Death of a Member

Baroness Hayman: My Lords, it is with regret that I have to inform the House of the death of Lord Jauncey of Tullichettle on 18 July. On behalf of the House, I extend our condolences to his family and friends.

Prisoners: Voting Rights

The Lord Bishop of Worcester: asked Her Majesty's Government:
	When the results of the consultations about voting rights for those serving custodial sentences, and the Government's response to those consultations, will be made known; and when any necessary legislation will be introduced.

Lord Hunt of Kings Heath: My Lords, the Government are considering how to take forward the implementation of the Hirst judgment in light of the first-stage consultation on this issue. The results of that stage will be published with the second consultation document, which will look at the practical issues of any possible enfranchisement of convicted prisoners.

The Lord Bishop of Worcester: My Lords, I thank the Minister for that reply. I notice that he did not give a timetable, so perhaps he will be able to enlarge a little in that respect. While I recognise that he has inherited this policy, does he agree that a consultation which excludes general enfranchisement and includes blanket disfranchisement—the former is the option most often chosen by other countries; the latter has been declared unlawful—and on which there has been quite a long delay, might send a signal to those whom we would least like to receive it that we take time over obedience to the law and choose what we want to follow and what we do not?

Lord Hunt of Kings Heath: My Lords, I understand that the right reverend Prelate is shortly to retire from your Lordships' House, and I am sure that all noble Lords join me in thanking him for his tremendous contribution to this House. However, for once I do not really agree with him. The consultative paper setting out a number of options was sent out towards the end of last year. I do not think it unreasonable not to include a general enfranchisement of all prisoners. The options that have been put forward are perfectly reasonable for discussion, and Ministers are considering the outcome of the consultation on them.

Lord Corbett of Castle Vale: My Lords, can my noble friend confirm that this disfranchisement dates back to the Forfeiture Act 1870? Given this Government's relentless thirst for change, most of which I welcome, is it not rather bizarre that British citizens registered as overseas electors who are in foreign jails are entitled to vote while their mates over here cannot do so? What about a bit of change there?

Lord Hunt of Kings Heath: My Lords, my noble friend is right to suggest that the current position of convicted prisoners in this country goes back many years. He is also right to point out certain inconsistencies. However, giving enfranchisement to convicted prisoners still serving sentences in this country is a complex issue and we will come to a conclusion on it only after very careful consideration.

Baroness Seccombe: My Lords, do the Government support this issue or not? I was not clear on that from the Minister's answer. Does he not agree that there are more important issues surrounding voting? It must be important to restore integrity to our voting system, particularly following the recent disasters of postal voting.

Lord Hunt of Kings Heath: My Lords, that is a little wide of the question of where the Government stand in relation to whether serving prisoners should receive voting rights. Until now, the Government have always considered that the right to vote is part of a social contract between individuals and the state. The loss of the right to vote, reflected in the current law, was thought by the Government to be a proper and proportionate punishment for breaches of that social contract which resulted in people's imprisonment. But we have received a judgment from the European Court and it is right that we consider its implications; that is why there is a consultation. I can assure noble Lords that the Government will not come to a decision without very careful thought indeed.

Lord Thomas of Gresford: My Lords, is it not right that the Government lost in the European Court of Human Rights, where it was found that blanket disfranchisement was clearly against Article 3 of Protocol 1 of the convention? Has not the Court of Session in Scotland followed that judgment? Surely the answer is an immediate remedial order by the fast-track procedure. At the moment we are in line with Armenia, Azerbaijan, Bulgaria, Estonia, Lichtenstein and Moldova, among others, in denying rights to vote to prisoners.

Lord Hunt of Kings Heath: My Lords, a considerable number of countries in the Council of Europe certainly take the same view as this country has always taken. I do not think an immediate remedial order is the right way forward. The Government made it clear that we would have a two-stage consultation process. We are looking at the conclusions of the first stage of consultation, and this will be followed by a further consultation. I do not think haste is required; very careful thought is needed.

Baroness Howe of Idlicote: My Lords, when they come to their conclusion, will the Government bear in mind that the aim of end-to-end offender management is rehabilitation? Surely one of the most important ways in which this can be stressed is that offenders retain citizenship—which they will be expected to use in a constructive way in future—while in prison.

Lord Hunt of Kings Heath: My Lords, that is certainly one way of looking at it. I also suggest that many people think there is an issue of rights and responsibilities and that, in this case, rights have to be earned.

Baroness Golding: My Lords, what progress has been made to enable people who are admitted to hospital close to a polling date to have their voting rights?

Lord Hunt of Kings Heath: My Lords, an emergency proxy system has been introduced recently whereby, up to 24 hours before the election, a person in that situation would be entitled to a proxy vote after making an application, or an application being made on their behalf, to the electoral registration officer. There has been some movement there.

Baroness Sharples: My Lords—

Lord Low of Dalston: My Lords—

Lord Rooker: My Lords, it is the turn of the noble Lord, Lord Low.

Lord Low of Dalston: My Lords, can the Minister explain why he thinks it is not unreasonable to exclude the option of general enfranchisement when it is already being operated, evidently successfully, in 18 Council of Europe countries and is being extended as we speak to others, including Ireland?

Lord Hunt of Kings Heath: Very simply, my Lords, the Government do not support the general enfranchisement of all prisoners. There seems little point in engaging in consultation on it.

Health: Tuberculosis

Baroness Sharples: asked Her Majesty's Government:
	How they intend to respond to present levels of incidence of human tuberculosis in light of current migratory patterns.

Baroness Royall of Blaisdon: My Lords, the Department of Health recommends that TB services follow the National Institute for Health and Clinical Excellence guideline on the prevention, treatment and control of tuberculosis. It contains specific guidance on the follow-up of new entrants. The advice is also emphasised in the toolkit recently published by the department to help NHS trusts plan, procure and deliver TB services relevant to the local demography and incidence of TB.

Baroness Sharples: My Lords, I thank the Minister for that reply. Having had TB in my teens, I know how infectious it is. Does she agree with me that everyone coming into this country for more than six months, specifically from the 22 burden countries that suffer very much from the disease, should be tested?

Baroness Royall of Blaisdon: My Lords, we currently have a pilot project with the seven countries in which TB is most prevalent, in which we test people before they receive their visas to come to the UK. That scheme is now being evaluated, and we will probably roll it out to more countries such as China and India on the basis of that evaluation.

Baroness Barker: My Lords, the Minister will be aware of the case of the American gentleman who recently travelled to Europe knowing that he had TB. Does that not assist the case of the noble Baroness, Lady Sharples, that, although TB has a higher incidence in some countries, it happens in most? How soon will that pilot project be rolled out and on what basis will it be extended to different countries, such as the USA?

Baroness Royall of Blaisdon: My Lords, the project is being evaluated. I do not know the timescale of the rollout, but I will inform noble Lords. It is true that tuberculosis is an infectious disease, but it is not very infectious. The incidence of TB in this country is grossly exaggerated in the press from time to time. I understand that at the beginning of this century there were about 100,000 people in this country with TB. That figure now stands at somewhere between 7,000 and 8,000.

Baroness Gardner of Parkes: My Lords, is the Minister aware—well, she is obviously not aware—that her statement about TB not being highly infectious is quite wrong? When I was a chairman of a local public health body, we had one contact who infected 40 people within one week. It is a highly infectious condition. Does she not think that, although you can do a certain amount in terms of immigration, it is very important to see that children are immunised against TB and protected in that way?

Baroness Royall of Blaisdon: My Lords, I respect the views expressed by noble Lords. However, I have been informed by the Department of Health that TB is quite difficult to catch and usually requires prolonged or repeated contact with a person with infectious TB, such as living in the same household. It is important that children who are going to be subjected to contact with people with TB are immunised, and for that very reason the Government now have a targeted approach to immunisation. All new-born babies who are living in areas where TB is prevalent will now be immunised.

Lord Hughes of Woodside: My Lords, has the apparent shortage of vaccine of about a year ago now been overcome? Is there plenty of vaccine available?

Baroness Royall of Blaisdon: My Lords, I was not aware that there had been a shortage of vaccine. I understand by that that now there is no such shortage. If that is not the case, I will inform noble Lords.

Lord Ramsbotham: My Lords, I am sure the Minister is aware that many incidents of virulent TB are coming into our prisons with foreign national prisoners. Is she satisfied that all primary care trusts are enabling all prisons that receive such prisoners to carry out the necessary tests on arrival and subsequent treatment?

Baroness Royall of Blaisdon: My Lords, that is something PCTs are working hard on with the Prison Service. The Government are considering extending the screening of target groups, and that may be something prisons and PCTs will be contemplating.

Baroness Tonge: My Lords, does the Minister agree that poor housing, in particular overcrowding, is a huge contributory factor in catching TB? What do the Government intend to do about this, particularly in the immigrant and asylum-seeker communities?

Baroness Royall of Blaisdon: My Lords, TB is prevalent in areas of poor housing and homelessness. I am sure that the Statement later today by my honourable friend Yvette Cooper will have a bearing on this.

Lord Skelmersdale: My Lords, can the noble Baroness explain how, in one breath, she talks about analysing a review and, in the next, about rollout to further countries before the review's analysis is complete? Can she explain the logic of that?

Baroness Royall of Blaisdon: My Lords, I will check Hansard, but I hope that I said that the rollout would be on the basis of the evaluation. First, we want to evaluate the pilot projects; thereafter, provided that the evaluation shows that the schemes should be rolled out, we will seek to do so.

Census: Carers

Baroness Pitkeathley: asked Her Majesty's Government:
	Whether they intend to retain questions about carers and caring in the 2011 census.

Lord Davies of Oldham: My Lords, the Office for National Statistics is still considering the inclusion of a question on carers in the 2011 census. The ONS recognises the importance of the topic and the value of the data. The question's inclusion is dependent on space available on the questionnaire and the user requirement for competing questions. The final decision on the content of the 2011 census will ultimately be for Parliament to make.

Baroness Pitkeathley: My Lords, I thank my noble friend for what I think was a hopeful Answer. Does he agree that the data provided by the 2001 census have been invaluable in gaining better recognition for carers? Does he also agree that at a time when the Government are trying to plan 10 years ahead for carers, with the review of the national strategy and so on, it is particularly important to have continuity and fullness of data, especially when we think about hard-to-reach groups, such as young carers and those from black and minority-ethnic communities?

Lord Davies of Oldham: My Lords, I agree with my noble friend; I merely bring to the attention of the House the fact that the question on carers is competing for inclusion against questions on second residence, citizenship, year of entry, qualifications, industry, income and language. They are all important questions, too, but my noble friend is right that the Government are developing their policy on carers and that the best possible information is required to that end.

Lord Swinfen: My Lords, with an ageing population, is it not essential that questions on carers be on the census form?

Lord Davies of Oldham: My Lords, that is an important factor. It is because of the ageing population and the increased numbers of carers that the question was included on the 2001 census. However, there are many competing demands for the important document that the census represents; decisions are still to be taken on the final nature of the question sheet, which is put before Parliament.

Lord Newby: My Lords, in response to a Parliamentary Question in another place last week, the National Statistician said that one of the principal determinants of which and how many questions would be asked in the census was cost. Can the Minister assure the House that questions on carers will not be excluded from the next census on the basis of cost constraints?

Lord Davies of Oldham: My Lords, the census is subject to an evaluation of cost-benefit analysis, like any other aspect of government. In fact, if a fourth page had to be introduced into the census, the rise in costs would be significant. There are many competing demands for the places on the three pages already identified. We cannot pretend that this issue does not have a cost dimension—it has. Nevertheless, as I said, the final decision on priorities rests with Parliament.

Baroness Hollis of Heigham: My Lords, does my noble friend accept that the very welcome improvement in the pension rights for carers that the Labour Government have introduced in the current Pensions Bill was based on information from the 2001 census data? I doubt whether, without it, we could have been so sure of our facts and the costs, and the improvement might not have happened. Will my noble friend take the opinion of the House and do his best to ensure that this question has the priority that it rightly deserves?

Lord Davies of Oldham: My Lords, I recognise my noble friend's representation on this matter. Of course, accurate statistics always aid policy. She will recognise that before the 2001 census the Government had already begun to develop their National Carers Strategy, giving priority to this area. She is right that accurate information assisted the development of the policy.

Lord Tebbit: My Lords, I suppose that I should declare an interest as a carer myself. Will the noble Lord encourage those responsible for taking this decision to look at which of the other competing questions could be answered more easily by other methods of opinion survey? Much of the information that we have gathered about the role and number of carers could not have been discovered in any other way. Taking that into account, surely we should look at putting that question on the census form as a priority.

Lord Davies of Oldham: My Lords, the noble Lord makes a most valuable contribution. That is a very important point. He will appreciate that we are increasingly concerned that we identify the number of carers and the necessary support for them in the very valuable work that they do. The other potential questions for the census—indeed, all questions—are examined with regard to whether the information could be gathered in any other way. I give one element of encouragement to the House, and a constructive response. The three departments for Northern Ireland, Scotland and Wales are in favour of a question on carers being on the census.

Baroness Massey of Darwen: My Lords, does my noble friend agree that there are a number of unknown carers such as grandparents? Does he further agree that children's services at a local level and collaboration between those services could be put at jeopardy by not knowing who those carers for children are?

Lord Davies of Oldham: My Lords, my noble friend speaks with great authority on this point and reinforces the importance of our having the maximum amount of information on carers. I merely emphasise again that such representations can be made on other priorities, too, which is why the Government are still evaluating the position as a whole. When they have done so, they will produce a White Paper and eventually an order, which will be put before both Houses of Parliament.

Earl Howe: My Lords, without wishing to labour this question more than necessary, perhaps I may follow up a point alluded to by the noble Baroness, Lady Pitkeathley. The Minister will know that, in the 2001 census, 175,000 young carers in the UK were identified, but it turns out that only 30,000 of those are currently known to carers support services. Will he bear in mind the usefulness of including a suitably worded question in the census to identify these young carers with a view to supporting them as appropriate?

Lord Davies of Oldham: My Lords, I accept the point that the noble Earl has made. The whole House is aware that we needed to develop a much greater understanding of the role and needs of carers than we had a decade ago. That is why the Government have made strenuous efforts in that regard. We are looking at whether other strategies and organisations can provide the requisite information for us, but I accept the point made on all sides this afternoon that the census could play a very important role in this respect.

Food: Labelling

Lord Taylor of Holbeach: asked Her Majesty's Government:
	Whether they propose to extend the country of origin definition in respect of food labelling.

Baroness Royall of Blaisdon: My Lords, food labelling is an area of EU competence. The European Commission is conducting a review of food labelling, and country of origin requirements are being considered as part of this. The UK has already indicated to the Commission that in principle it is in favour of an extension to the rules, subject to satisfactory cost-benefit analysis.

Lord Taylor of Holbeach: My Lords, I declare an interest as a British farmer and grower. I am sure that the noble Baroness will agree with me that British shoppers would prefer to buy food from British farms. At the moment, it is possible for all the constituent parts of a processed product to be produced abroad and for it still to be labelled as British if it is processed or packed here. What does the Minister propose to do to close that loophole?

Baroness Royall of Blaisdon: My Lords, I wholeheartedly agree that we all prefer to buy British produce from British farmers and producers whenever possible. The FSA produces assisting guidance, as the noble Lord may be aware. It advises, for example, that bacon produced from imported pork should be labelled "Made from Danish pork cured in Britain" or something similar. FSA guidance is extremely important. All the issues raised by the noble Lord will be taken into account in the context of the European Commission review, because we want to ensure that more people buy British whenever possible.

Lord Swinfen: My Lords, given that Welsh lamb exported to France and butchered there can be labelled as French, what is being done to make certain that the French understand that it is Welsh not French lamb?

Baroness Royall of Blaisdon: My Lords, the fact that these are European rules should mean that they are consistently applied throughout the European Union; therefore, I hope that the standards will be upheld in France as they are in the United Kingdom.

Baroness Barker: My Lords, will Her Majesty's Government, as part of the EU review, recommend that, across the EU, product-origin marks be given solely to meat from animals born, reared and slaughtered in the same country?

Baroness Royall of Blaisdon: My Lords, I am sorry for a very tedious reply but, again, the review will look at whether it will be cost-effective and appropriate for a label to give information about where meat products are reared and so on.

Lord Dubs: My Lords, does my noble friend agree that, whatever legal requirements come from Brussels, many people in this country would like not only that producers label their products as being of British origin, but to know how local they are to the point of purchase. The success of farmers' markets indicates that people want to buy not just British but as local as they can. Will the Government encourage supermarkets and producers voluntarily to label in such a way that we know just how local a product is?

Baroness Royall of Blaisdon: My Lords, producers are at liberty to put that information on their products now. As the noble Lord suggests, it is a voluntary scheme. As I shop in many farmers' markets and in supermarkets I note that more and more products indeed have labels going into great detail about the locality in which they are produced. I, for one, always buy those products.

Baroness Oppenheim-Barnes: My Lords, is the Minister aware that I introduced country of origin markings legislation in 1980 but subsequently it had to be withdrawn because the EU described it as a non-tariff barrier? I am delighted to hear that it appears to be changing its mind. I hope, too, that it will change its mind about the ridiculous E numbers in foods, which cover up a number of toxic substances and are incomprehensible to the public.

Baroness Royall of Blaisdon: My Lords, I congratulate the noble Baroness on her far-sighted proposed legislation in the previous Conservative Government. I note what she says about E numbers, but that is a rather different question.

Baroness Tonge: My Lords, what progress is being made in ensuring that food grown in the Occupied Territories of Palestine, including the settlements, is labelled as grown in Palestine and not labelled as Israeli?

Baroness Royall of Blaisdon: My Lords, I do not have that specific information to hand but I know that Her Majesty's Government pay great attention to it. We want to ensure that more people are aware of produce that is produced by Palestinians in their territories.

Baroness Byford: My Lords, further to the Minister's first reply, if the EU decides not to change the present circumstances, what will the Government do about it?

Baroness Royall of Blaisdon: My Lords, as ever, the Government will make very firm, strong and robust representations in the European Union.

Business

Lord Grocott: My Lords, we shall have two Statements repeated today, after the debate on the Corporate Manslaughter and Corporate Homicide Bill. The first, on flooding, will be repeated by my noble friend Lord Rooker, and the second, on housing, by my noble friend Lady Andrews.

Private Security Industry Act 2001 (Amendments to Schedule 2) Order 2007

Regulation of Investigatory Powers (Investigation of Protected Electronic Information: Code of Practice) Order 2007

Regulation of Investigatory Powers (Acquisition and Disclosure of Communications Data: Code of Practice) Order 2007

Railway Pensions (Transfer of Pension Schemes) Order 2007

Lord Grocott: My Lords, I beg to move the four Motions standing in the name of my noble friend Lord Bassam of Brighton on the Order Paper.

Moved, That the draft orders laid before the House on 4, 7 and 11 June be approved. 19th Report from the Statutory Instruments Committee, considered in Grand Committee on 17 July.—(Lord Grocott.)
	On Question, Motions agreed to.

Terrorism (Northern Ireland) Act 2006 (Transitional Provisions and Savings) Order 2007

Regulatory Reform (Deer) (England and Wales) Order 2007

Lord Rooker: My Lords, I beg to move the two Motions standing in my name on the Order Paper.
	Moved, That the draft orders laid before the House on 28 June and 5 July be approved. 22nd Report from the Statutory Instruments Committee and 12th Report from the Regulatory Reform Committee, considered in Grand Committee on 17 July.—(Lord Rooker.)

On Question, Motions agreed to.

Companies Act 2006 (Commencement No. 3, Consequential Amendments, Transitional Provisions and Savings) Order 2007

Scotland Act 1998 (Transfer of Functions to the Scottish Ministers etc.) Order 2007

Scottish Parliament (Elections etc.) (Amendment) Order 2007

Lord Evans of Temple Guiting: My Lords, I beg to move the Motions standing in my name on the Order Paper.
	Moved, That the draft orders laid before the House on 20 June and 2 and 9 July be approved. 21st and 23rd Reports from the Statutory Instruments Committee, considered in Grand Committee on 17 July.—(Lord Evans of Temple Guiting.)

On Question, Motions agreed to.

European Communities (Definition of Treaties) (Stabilisation and Association Agreement) (Republic of Albania) Order 2007

Baroness Royall of Blaisdon: My Lords, I beg to move the Motion standing in my name on the Order Paper.

Moved, That the draft order laid before the House on 20 June be approved. 21st Report from the Statutory Instruments Committee, considered in Grand Committee on 17 July.—(Baroness Royall of Blaisdon.)
	On Question, Motion agreed to.

Housing Benefit (Loss of Benefit) (Pilot Scheme) Regulations 2007

Lord McKenzie of Luton: My Lords, I beg to move the Motion standing in my name on the Order Paper.

Moved, That the draft regulations laid before the House on 20 June be approved. 21st Report from the Statutory Instruments Committee, considered in Grand Committee on 17 July.—(Lord McKenzie of Luton.)
	On Question, Motion agreed to.

Parliamentary Constituencies (Amendment) Bill [HL]

Read a third time, and passed, and sent to the Commons.

Corporate Manslaughter and Corporate Homicide Bill

Baroness Ashton of Upholland: My Lords, I beg to move that the Commons amendments be now considered.

Moved accordingly, and, on Question, Motion agreed to.
	[The page and line references are to HL Bill 19 as first printed for the Lords.]
	Page 2, line 29, at end insert-
	"(d) a duty owed to a person who, by reason of being a person within subsection (1A), is someone for whose safety the organisation is responsible.
	(1A) A person is within this subsection if-
	(a) he is detained at a custodial institution or in a custody area at a court or police station; (b) he is detained at a removal centre or short-term holding facility;(c) he is being transported in a vehicle, or being held in any premises, in pursuance of prison escort arrangements or immigration escort arrangements;(d) he is living in secure accommodation in which he has been placed;(e) he is a detained patient."
	Page 3, line 12, at end insert-
	""custodial institution" means a prison, a young offender institution, a secure training centre, a young offenders institution, a young offenders centre, a juvenile justice centre or a remand centre;"detained patient" means-
	(a) a person who is detained in any premises under-
	(i)Part 2 or 3 of the Mental Health Act 1983 (c. 20) ("the 1983 Act"), or
	(ii)Part 2 or 3 of the Mental Health (Northern Ireland) Order 1986 (S.I. 1986/595 (N.I. 4)) ("the 1986 Order");
	(b) a person who (otherwise than by reason of being detained as mentioned in paragraph (a)) is deemed to be in legal custody by-
	(i)section 137 of the 1983 Act,
	(ii)Article 131 of the 1986 Order, or
	(iii)article 11 of the Mental Health (Care and Treatment) (Scotland) Act 2003 (Consequential Provisions) Order 2005 (S.I. 2005/2078);
	(c) a person who is detained in any premises, or is otherwise in custody, under the Mental Health (Care and Treatment) (Scotland) Act 2003 (asp 13) or Part 6 of the Criminal Procedure (Scotland) Act 1995 (c. 46) or who is detained in a hospital under section 200 of that Act of 1995;
	"immigration escort arrangements" means arrangements made under section 156 of the Immigration and Asylum Act 1999 (c. 33);"
	Page 3leave out line 25
	Page 3, line 25, at end insert-
	""prison escort arrangements" means arrangements made under section 80 of the Criminal Justice Act 1991 (c.53) or under section 102 or 118 of the Criminal Justice and Public Order Act 1994 (c. 33);"removal centre" and "short-term holding facility" have the meaning given by section 147 of the Immigration and Asylum Act 1999 (c. 33);"secure accommodation" means accommodation, not consisting of or forming part of a custodial institution, provided for the purpose of restricting the liberty of persons under the age of 18."
	Page 3, line 37, leave out "or (b)" and insert ", (b) or (d)"
	Page 5, line 8, leave out "or (b)" and insert ", (b) or (d)"
	Page 6, line 43, leave out "or (b)" and insert ", (b) or (d)"
	Page 13, line 3, at end insert the following new Clause:-
	"Power to extend section 2(1A)
	(1) The Secretary of State may by order amend section 2(1A) to make it include any category of person (not already included) who-
	(a) is required by virtue of a statutory provision to remain or reside on particular premises, or(b) is otherwise subject to a restriction of his liberty.
	(2) An order under this section may make any amendment to this Act that is incidental or supplemental to, or consequential on, an amendment made by virtue of subsection (1).
	(3) An order under this section is subject to affirmative resolution procedure."
	Page 13, line 20, at end insert-
	"( ) An order bringing into force paragraph (d) of section 2(1) is subject to affirmative resolution procedure."
	As an amendment to the Clause inserted into the Bill after Clause 19 by Lords Amendment No. 33:-
	Line 30, at end insert-
	""premises" includes land, buildings and moveable structures;"

Baroness Ashton of Upholland: My Lords, I beg to move Motion A, That the House do not insist on its Amendments Nos. 2, 3, 5, 6 and 10, or on its Amendments Nos. 10P and 10Q proposed in lieu of Commons Amendments Nos. 10K to 10N, and do agree with the Commons in their Amendments Nos. 10R, 10S, 10T, 10U, 10V, 10X, 10Y, 10Z and 10AA in lieu of Lords Amendments Nos. 2, 3, 5, 6, 10, 10P and 10Q.
	We turn to the discussion of fresh amendments sent to us from another place. It might be helpful if I say a few words about the deadline for considering the Bill. The noble Lord, Lord Hunt, and other noble Lords raised the question of the deadline in our previous discussions and noble Lords will be aware from previous debates that, under the procedures of the other place, proceedings on a Bill that has been carried over from the last session—as was the case for this Bill—must be complete within 12 months of the Bill being introduced unless that period is extended. That period has been extended, by a week, to provide the other place and your Lordships' House with further time to consider the very significant further amendments that the Government have brought forward.
	The nub of concern with the Government's amendments so far has been that they would leave a discretion whether to extend the offence to custody. The further amendments tabled by the Government remove that doubt by extending the relevant duties of care in the Bill to include duties owed to those in custody. In a nutshell, the amendments make custody an integral part of the offence. I hope that noble Lords will agree that that is a very significant change. This is achieved by Amendment No. 10R, which also sets out a wide definition of custodial environments that will be covered. This comprehensively addresses the forms of custody identified in the amendments proposed in your Lordships' House.
	There is also a power, subject to the affirmative procedure, to amend the definition to include further forms of detention. This does not allow the definition as currently set out to be restricted or for exceptions to that definition to be made—I think that your Lordships will agree that those are important points—but it provides some flexibility to add further forms of custody or analogous circumstances if required.
	I am aware that the noble Lord, Lord Goodhart, as chairman of the Delegated Powers and Regulatory Reform Committee, was concerned to know what this power might be used to cover. I am grateful that he spent a few minutes with me earlier to explain his concerns. Examples might be facilities used for custody by Her Majesty's Revenue and Customs or detention in penal military establishments. There might be a case for extending to premises such as approved probation or bail hostels. However, there is no intention to extend this to areas that do not involve any forms of custody or detention in premises designed for holding people. That, at least in part, addresses his concerns, and I have already indicated that the Government will write to him in his capacity as chairman of the Delegated Powers Committee to ensure that all his concerns are covered.
	The commencement of the new offence in respect of custody will be subject to an affirmative order. That is provided by Amendment No. 10Z. I will return to the question of timing in a moment. However, there has been widespread recognition of the need to provide some delay before this aspect of the legislation is commenced. Providing for commencement by affirmative order explicitly recognises that intention.
	These amendments bridge a gap that has troubled many in this House by moving from a discretion to extend the offence to custody to making this an integral part of the offence. That is a significant movement by the Government and I very much hope that these amendments will receive support from your Lordships' House. I welcome the fact that the amendment to my Motion in the name of the noble Lord, Lord Ramsbotham, does not seek to disagree with the amendments.
	I turn now to the question of timing. In providing for custody to be an integral part of the Bill, the Government are starting a clear process towards extending the offence to custody. However, as I and other noble Lords, including my noble friends Lord Rosser and Lord Lea, have explained on previous occasions, there are complexities in extending the new offence to custody. It is important that this process is managed properly in consultation with the services that will be affected. My right honourable friend the Secretary of State for Justice explained in the other place last week that:
	"There are anxieties in the police and the Prison Service that unless they have time to understand fully the extent of these obligations and take steps to implement them, the services—not at a senior level, but at a lower level—will start to become risk averse, and that could have many serious consequences".—[Official Report, Commons, 18/7/07; col. 333.]
	Against that background, the Secretary of State went on to suggest that he considered that a reasonable delay would be between five and seven years.
	Concerns have been raised that that sort of timetable does not provide the necessary impetus to take matters forward, and the Government are prepared to recognise and to respond to those concerns. For that reason, I give noble Lords an assurance that the sort of timetable that the Government will aim for will be the three-year period from commencement that the noble Lord, Lord Ramsbotham, suggests in his amendment to the Motion.
	However, I say that on the basis that noble Lords should not underestimate the difficulties facing the Prison Service and the police. There is very considerable pressure on the capacity of the Prison Service, as noble Lords know. Now is not the time to debate why that is the case and the measures the Government are taking to address those pressures. However, it must be recognised that there are serious pressures and demands imposed on staff, and that the Prison Service has a difficult responsibility for managing those pressures in a way that is safe for staff and inmates. We should also not underestimate the considerable challenges the police face day to day in managing people coming into police custody. Noble Lords will be aware that because of the condition and demeanour of many of these people, this is a dynamic and occasionally volatile environment in which it is difficult to entirely eliminate risk. I know that the Prison Service, through the custody improvement programme and the publication of guidance on safer detention last year, is taking its responsibilities for those in its custody very seriously.
	My right honourable friend the Secretary of State for Justice said that there would be annual reports on progress towards commencing this part of the Bill, and there will be significant developments between now and when a report is produced next year. The review that the noble Lord, Lord Carter of Coles, is undertaking on the supply and demand of prison places will have reported, and assessments will be available of the progress that police forces are making towards complying with the safer detention guidance issued in February last year.
	The exact timetable must be subject to further evaluation in light of these developments. It may therefore look more like the five years that my right honourable friend the Secretary of State for Justice referred to. However, I give the assurance that the Government will start out on this process with a timetable of three years in mind. In doing so, we will give careful consideration to the possibility of staged implementation. I very much hope that earlier progress could be made on some of the various forms of custody listed in Amendment No. 10R. On that basis, I hope that noble Lords will feel able to support the Bill as it now stands.
	Writing a timetable into a Bill will set this in stone. I hope I have made it clear that there are significant issues about the extension of the offence, and that we are at the start of a process of applying the offence to custody. I have provided what I hope is real reassurance, setting an ambitious timetable that the Government will work towards. But, as noble Lords will recognise, we must be able to assess progress against that and see where things stand, and the annual report will enable noble Lords to see progress to date. I therefore hope that noble Lords will not seek to act further and fix the timetable in legislation.
	I very much hope that we are today at the end of our debates on this legislation. I am now in a position to put the Bill on the statute book. The Government have offered considerable further movement, and custody will now appear as an integral part of the offence. I have offered assurances about the timetable for commencing that part of the legislation. I hope your Lordships' House will accept these commitments and not send the Bill back to another place.
	Moved, Motion A, That the House do not insist on its Amendments Nos. 2, 3, 5, 6 and 10, or on its Amendments Nos. 10P and 10Q proposed in lieu of Commons Amendments Nos. 10K to 10N, and do agree with the Commons in their Amendments Nos. 10R, 10S, 10T, 10U, 10V, 10X, 10Y, 10Z and 10AA in lieu of Lords Amendments Nos. 2, 3, 5, 6, 10, 10P and 10Q.—(Baroness Ashton of Upholland.)

Lord Ramsbotham: rose to move, as an amendment to Motion A, Motion A1, at end insert "but do propose the following amendment to Commons Amendment 10Z—
	Line 3, at end insert-
	"( ) If no order is made under subsection (1) bringing into force paragraph (d) of section 2(1), that paragraph shall come into force following the expiry of a period of three years following the commencement of the other provisions of this Act.""

Lord Ramsbotham: My Lords, like every other Member of this House, I am sure, I am immensely reassured by what the Minister has just told us. On many occasions in previous debates on this subject, Members of your Lordships' House have paid tribute to her, not just for her willingness to engage in discussion with us but for the way she has represented the case in this House and, more importantly, within government and behind the scenes, as it were. I am sure she must have played a considerable part in enabling this satisfactory conclusion to be reached. I am sure we all pay great tribute to her.
	I also pay great tribute to the Secretary of State in another place, because he has changed his position considerably over the last four weeks, influenced, I am sure, by the noble Baroness. Nevertheless we have been given his assurance as well as hers, so it would be churlish to press for more. My reason for tabling this amendment was my concern that seven years was too long. It represented more than the life of this Parliament and probably the life of the next Parliament as well. As an ex-soldier, I could not help remembering that D-day was planned and executed in one-quarter of that time. I suspect that the complexities of the Bill are nothing compared with that operation.
	The noble Baroness rightly mentioned that there are things to be done and issues to consider with the police and prisons. Like me, my noble friend Lord Dear was delighted to hear what has happened. If possible, he will want to be involved in any discussions in which he can help to take the matter forward.
	It is right to recognise that this has been a long time in coming. When we last debated it, the noble Baroness said that she hoped that this would not be the way in which business was conducted and that discussion about such matters before they reached the Floor of the House was much more satisfactory. I agree, but it has been very interesting that this House has consistently stuck to this line without wavering. I am sure that victims up and down the country will be very glad of the outcome.
	I must admit that as a novice I am not sure of the procedure involved. Other Members may wish to speak. I think that it would perhaps be courteous and sensible to bid to withdraw my amendment.

Noble Lords: Not yet.

Lord Ramsbotham: Not yet, my Lords? I stand corrected. I beg to move.
	Moved, as an amendment to Motion A, Motion A1, at end insert "but do propose Amendment No. 10AB to Commons Amendment 10Z".—(Lord Ramsbotham).

Lord Dholakia: My Lords, I thank the noble Lord, Lord Ramsbotham, for his robust stand on this issue. To an extent, he has achieved considerable progress. The House Magazine nominated the noble Lord for Peer of the Year and the votes in your Lordships' House confirmed him as that. He deserves all the congratulations he has received because of the stand that he has taken on this matter.
	I am disappointed for a number of reasons. When I last looked at the figures, we had, on average, two deaths in custody per week. I am disappointed about the timescale—that it will take another three years before we come to a conclusion on this matter. I am disappointed that in the mean time there will be this exemption; I will explain that. I am also disappointed for those who lost their dear ones through deaths in prison; with future deaths, others will have to wait even longer to reach a conclusion.
	Our stand has been clear from day one. A law that distinguishes between the private and public sectors—or between the private sector and the private sector working in the public sector, as is the case with prisons—is a bad law. There should be uniform application, but that is lacking. We thank the Minister for her assurance that the Government hope to put the situation right at the end of three years.
	I am also concerned about the prison population; that was one of the Minister's arguments. The prison population is increasing day by day in this country and I cannot see that in three years' time we will be any better off than we are now. The problem will still be there. I also believe that, with the increase in terrorism in this country, accidents will happen, and there may be shootings. There should be some accountability about such deaths.
	I am disappointed by the long timescale involved. What are the interim plans within the three-year period? It would be helpful if the Minister explained that. We have gone as far as we can on this matter. If the noble Lord presses the amendment there will be further ping-pong, but I understand that he now intends to call it a day; we respect his wishes. If he had called a Division, we on this side would certainly have supported him. However, I promise that the matter will not end when this debate finishes. We will take every available opportunity, in Questions and short debates, to raise this issue until such time as it is on the statute books. Let common sense prevail: our shortcomings and rising prison population should not hinder progress in this very important matter.
	In conclusion, I thank the Leader of the House for her courtesy and kindness in keeping us informed at every stage. She has truly acted as the Leader of the whole House and we are very grateful to her.

Lord Hunt of Wirral: My Lords, I agree with the comments of the noble Lord, Lord Dholakia, about the role of the Leader of the House. I add the thanks of these Benches for the way in which she has persuaded her ministerial colleagues. She will downplay the extent to which she has persuaded them, but we all know the extent to which she has put forward views from all sides of this House.
	Today we have before your Lordships' House virtually 99 per cent of the package of amendments put forward in the other place. These are a close replica—with some welcome enhancements—of the package of amendments tabled by the noble Lord, Lord Ramsbotham, and repeatedly supported by noble Lords in a series of extraordinary and profound debates. It is a moment for congratulating noble Lords on the way in which they have upheld the rule of law. The principle that all are equal in the eyes of the law should apply.
	Noble Lords are also to be congratulated on upholding the rights of those in custody and in the hands of the state. Often the most vulnerable in our society, they must be owed a duty of care. This is a partial victory, but by no means a Pyrrhic victory. We have ensured, through proper pursuit of a vital point of principle, that ours is a system that will ultimately submit itself to the same tests of competence and decency that it imposes on others.
	I share the frustration of the noble Lord, Lord Dholakia, at Amendment No. 10AA, in the Government's name, which still separates the implementation of different strands of the Bill. Whereas the Secretary of State confirmed in the other place that the various measures in the Bill will be implemented on 6 April next year, the application of the offence to deaths in custody remains out on a limb. Its introduction is not legally binding; it is not committed to in word or law. We have, however, had a number of key concessions. Mr Straw said:
	"We have shifted; there is no question about that".—[Official Report, Commons, 18/7/07; col. 337.]
	Well, good on you, your Lordships. He went on to say that he very much hoped to implement these key provisions in less than the period of five to seven years.
	I thank the Minister for coming forward today and saying that the Government will work to a timescale of three years. However, this is still only an enabling power on the face of the Bill. I would be wrong not to express my disquiet about that. There are just under 100 provisions in the Criminal Justice Act 2003 that remain neither enacted nor repealed, wholly or partially. It is sad but true that this Government have form on omitting to enact provisions in legislation. The Minister has persuaded us that she means business. It is her personal undertaking on this that I hold most dear and most valuable.
	It has been a difficult time. I can imagine the pressures that have been put on the noble Lord, Lord Ramsbotham. He is a Cross-Bencher. Often in this House the Cross-Benchers take a key lead in putting forward a point of principle, and I congratulate him on the way in which he has taken forward this very important issue. He has constantly stressed the importance of recognising that, in enacting this legislation, the families of those who have been bereaved in these terrible circumstances are just as important as the families of those who have been bereaved in other circumstances.
	I am ever mindful of the wise words of my honourable friend in the other place, Dominic Grieve, who observed that the Government's response to private institutions that have found it difficult to convert to health and safety legislation in the past has been quite simply, "Tough". Tough is exactly what I hope the Government will be: tough in the test that they set themselves and those for whose shortcomings they are ultimately responsible, and tough on any institutions that, through grossly negligent senior management, fail to prevent unnecessary loss of life among their inmates.
	In conclusion, I pay tribute to the noble Lord, Lord Ramsbotham, and to the other noble Lords who have supported him. Appropriately and deservedly, last week he was named and celebrated as Peer of the Year. Thanks to his vision, persistence and unflagging energy, justice will be done—sadly, not today or tomorrow, but perhaps one day.

The Lord Bishop of Worcester: My Lords, I would not wish to find myself against the noble Lord, Lord Ramsbotham, and I am not at all surprised that his persistence has borne fruit in the way that it has.
	I am very grateful to the Lord President for the way in which she has spoken. If we are at the end of a process, that itself must be a good thing. However, she said one thing about which I should like to voice a word of concern. If I understood correctly, she said that one reason why it was important that we did not put a timetable into the Bill was that the service or services might have difficulty adjusting to what the Bill requires. If I heard her correctly, she went on to say that the concern was about not the senior levels of the service but the junior levels. When I heard her say that, I thought, "Yes, I know what you mean, and it is what we often say, but it is an argument about which we should be extremely cautious". If, in some meeting of bishops, I catch myself saying that of course I agree with something but I could not possibly expect people back home to go along with it, I always know that I am on a difficult wicket.
	The task of legislation and, if I may say so, of government and senior levels in the service is to set an ethos that is absolutely clear. If that happens, it enables change, but change does not happen if people at the lower levels of institutions suspect that secretly the people at the higher levels are not very committed to the change. Time and again, I have seen people of great vulnerability cared for in places only because a very clear policy has been set by the people in charge. I only hope that this possibility of delay is not wrongly attributed to people at a lower level but that we who have the opportunity to form an opinion about this matter make the ethos that we require absolutely clear. I am sure that that is true of the Lord President, but that form of argument needs to be noticed when it is brought into play.

Baroness Ashton of Upholland: My Lords, I am very grateful for the spirit in which noble Lords have taken forward our debates on these amendments put down by the Government in another place. I have already congratulated the noble Lord, Lord Ramsbotham, on his award, which he rightly deserved. I was up against him for it but I am very pleased that he won it. It is also fair to say that we have been at great pains, in all our deliberations, to ensure that noble Lords who have quite reasonably believed that this is a point of great principle have not felt that either the Government or I, representing the Government, have seen it as anything else. I make it clear that those who feel strongly that the Bill is important were well represented by noble Lords who felt equally strongly. I think particularly of the noble Lord, Lord Hunt of Wirral, but also of noble Lords from across your Lordships' House.
	I was delighted that the noble Lord, Lord Ramsbotham, said that we had reached a very satisfactory conclusion, for I hope that today will mark the end of this part of the process and the beginning of what we need to do next. The noble Lord's disappointment about the timetable was echoed in particular by the noble Lord, Lord Dholakia. I know that it was felt that, although my right honourable friend the Secretary of State had put a timetable on this, that was some considerable time away. I hope that my words about an ambitious timetable of three years, which my right honourable friend the Secretary of State gave me to use today, will be well recognised as being what the Government seek to reach.
	The noble Lord, Lord Ramsbotham, also talked about discussion outside your Lordships' House. I want to reiterate that one ambition of mine, as Leader of the House, is that we deal with many of these matters away from the Floor of the House, so that when they come to your Lordships we have had the benefit of such debate and discussion as can take us through some difficulties and, I hope, to some kind of conclusion. That will not always happen, but in my experience it has been a good way to conduct our business. I pay tribute to all noble Lords who have given me their time in order for me to understand fully their concerns and to enable me and others to reflect them in discussion with my right honourable friend and others.
	I know that the noble Lord, Lord Dholakia, is disappointed, but he will agree that the issue of deaths in custody will not be addressed by this legislation alone. Indeed, our debates during the passage of this Bill and on other legislation have shown the importance of trying to tackle effectively situations that may be about suicide or worse. The way to approach this legislation is to see it as part of a jigsaw puzzle, not the answer in itself.
	The noble Lord, Lord Dholakia, mentioned interim plans. We have talked already about the annual report to your Lordships' House and to another place. Discussions will begin, and I am mindful that noble Lords may wish to participate in those, at least initially; it is up to your Lordships how far to take that forward. I expect noble Lords to continue to debate this through questions in your Lordships' House and in the other place and to represent the views of this House through making contact with my right honourable friend the Secretary of State, not least through my noble friend Lord Hunt of Kings Heath, to whom the implementation of this will now fall in his capacity as a Minister. We could not do any better than to rest with him on that. We have put this in the Bill in this way partly to enable us, as I indicated, to stage implementation so that, as we are ready, we can come in even more quickly than my right honourable friend has indicated. I hope that noble Lords will see that as a useful way to address, at least in part, their disappointment and concern.
	I say to the right reverend Prelate that we have discussed the issue of being risk-averse many times in my dealings with this legislation. The second time that this legislation was received in your Lordships' House—in ping-pong, as we call it—we discussed those feelings on health and safety questions. I will not go into those again; suffice it to say that I was not trying to suggest that the people on the ground floor, if I may put it like that, within the Prison Service or the police would be less likely to wish to see this legislation or, indeed, to participate in what will happen. We simply have to be mindful of the impact that any new legislation has on those on the front line who must implement it, and to be sure that we have set it out correctly and properly. Noble Lords will know that that applies in a whole range of areas, not least here. That was really the point that I was seeking to make, but clearly I did not make very well.
	I hope that we are done with the Bill. There will be a great deal of support for this piece of legislation to make it on to the statute book. I am grateful to noble Lords, today and on other occasions, as well as outside the Chamber. I hope that the noble Lord will withdraw his Motion so that we may now put this on to the statute book and move forward to the next phase.

Lord Ramsbotham: My Lords, I thank the Leader of the House for her kind remarks and for the gravity with which she has summed up not only this debate, but the many others that we have had, as the noble Lord, Lord Hunt of Wirral, said. An enormous amount of humanity and good sense has come out of these debates. When the matter was in the other place, I was heartened by a remark made by the Secretary of State. He said:
	"I am happy to provide regular reports ... at least once a year and, if there is a demand for it, more often than that".—[Official Report, Commons, 18/7/07; col. 335.]
	I can assure him that there will be a demand. Now that we have, as the noble Baroness said, launched the initiative, there are those who will want to make certain that the momentum is maintained, which is a good military principle.
	I take the opportunity of thanking all noble Lords who have taken part in the various debates on these amendments and who have voted. In particular, I thank the noble Lords, Lord Hunt of Wirral and Lord Dholakia, not only for their kind and generous remarks but also for their tremendous support. I also thank the noble Lord, Lord Lea of Crondall, who is not in his place. It has been a fascinating experience to discuss all the nuances of the Bill as we have proceeded through the various stages.
	This morning I was in Wormwood Scrubs and was reminded of one complexity that may need to be ironed out. The complaint is that prisoners arrive so late that it is often difficult to sort out who should go into which cell. They arrive late because the drivers of the vans are also court officials. They cannot start driving until the court has closed, which means that prisoners are delivered too late. That is because resources do now allow for two separate people to do two separate jobs. If that sort of complexity is going to be ironed out to make a better Prison Service and a better prison system, the stimulus of the Bill will have had another valuable purpose. But, in the spirit of all that has been said and, as I say, thanking all those who have taken part, in particular the Minister, I beg leave to withdraw the Motion.

Motion A1, by leave, withdrawn.
	On Question, Motion A agreed to.

Flooding

Lord Rooker: My Lords, with the leave of the House, I shall now repeat a Statement currently being made by the Secretary of State for the Environment, Food and Rural Affairs in the other place. The Statement is as follows:
	"With permission, Mr Speaker, I would like to make a Statement about the serious flooding that occurred over the weekend."A band of rain swept across central and southern England on Friday, developing into intense rainstorms. In 24 hours, up to 160 mm, that is six and a half inches, of rain fell. With already saturated ground, this rapidly entered rivers and drainage systems, overwhelming them. "Transport was severely disrupted, with the M5 and M50 affected and train services unable to run. Many local roads in flood-hit areas remain closed and the public are advised not to travel in the worst hit areas. "The most serious flooding has been experienced across central England, and in particular in Worcestershire, Warwickshire, Herefordshire, Gloucestershire, Lincolnshire, Oxfordshire and Berkshire. I must emphasise that this emergency is far from over and further flooding is very likely as the Thames and the Severn fill with flood waters from within their catchments."There are currently eight severe flood warnings in place, covering the Severn, the Thames and the Great Ouse in Bedford. Fifty other flood warnings are in place across England and Wales."We believe that up to 10,000 homes have been or could be flooded. Our thoughts are, of course, with all those whose lives have been so badly affected by the floods. In addition, up to 150,000 properties in the area including Tewkesbury, Gloucester and Cheltenham have lost, or risk losing, mains water following flooding of the Mythe water treatment works at Tewkesbury. This loss of water supply is serious and we do not expect houses to have service restored for some days. Severn Trent, the water company, is making provision for some 900 bowsers to be deployed and refilled by tankers, for those people without mains water. The company reports that about 240 bowsers are already in place and priority is being given to hospitals and vulnerable customers. "Precautionary notices to boil water have also been issued in Sutton, Surrey, following rain water getting into treated water storage. Electricity supply is also a concern. A number of electricity sub-stations have been affected by flood water, and about 45,000 properties have lost power, including at Castle Mead and Tewkesbury. A major National Grid switching station at Walham, Gloucester, remains under threat, which could result in 200,000 additional properties or more losing their supply. This would have a knock-on effect on water supplies."Yesterday evening, Armed Forces personnel were drafted in to help fire service and Environment Agency staff to erect a kilometre-long temporary barrier around the site and to start pumping out 18 inches of flood water behind the barrier. So far, these defences are holding but the water is still rising, so it is touch and go. If it does flood, the National Grid will be used as far as possible, but properties in the affected area will lose power. Contingency planning is underway to ensure continuity of essential services and supplies. "Last night, the Prime Minister chaired a meeting of COBRA and today he visited Gloucester. Other ministerial colleagues and I have also been to see the problems first hand, in my case visiting Worcester, Evesham and Gloucester yesterday."I am sure the whole House will wish to thank the emergency services, the Armed Forces, staff from the Environment Agency, local councils and the utilities, and others for the way in which they have worked together in implementing the emergency plans. I would also like to thank local communities for their huge effort in helping each other."Because this emergency continues, I would ask the public to listen out for flood warnings, particularly on local radio stations; to contact the Environment Agency floodline on 0845 9881188; to respond to advice about evacuation; and to look out for neighbours and anyone who may be vulnerable as a result of flooding, or loss of power and/or the water supply. People should not go into flood water and children should certainly not play in it. Even six inches of fast moving water can knock people off their feet, and the water will often be polluted or hide dangers. "As the waters recede, the clear-up will begin. The revised Bellwin rules will assist local authorities in the areas affected to cover the immediate costs of dealing with the flooding and its aftermath, and the Government will now look at the support required for these areas. And we will also increase funding for flood defences to £800 million by 2010-11, as I informed the House on 2 July."Finally, the review which I have set up to learn the lessons from the floods of this summer will, of course, look at what has happened over the past three days. I have decided that I will ask an independent person to oversee the review. I will keep the House informed of developments".
	My Lords, that concludes the Statement.

Baroness Byford: My Lords, I thank the Minister for repeating the Statement and join him in thanking all those who help to try to sort the problem out; the professionals in whatever capacity, or the volunteers trying to help others in dreadful circumstances. It is awful to have one's own home invaded, but of course a lot of businesses have been affected as well.
	We welcome the Prime Minister's review but there are some questions that I would like to ask. The Statement is brief. I do not mean that in a derogatory manner; it is as it is because it comes fairly soon after the emergency. The Statement clearly says that the Armed Forces were asked to help "yesterday evening", which was Sunday. Why were they were not called out earlier? It seems strange that it has taken so long to do that.
	Secondly, of the money which is being put forward under the Bellwin rules to help flood defences in the future—some £800 million by 2010-11—how much will be allocated immediately up front? I suspect that most of us hope that a lot of that money will be moved early, rather than waiting to be updated in later years. I presume that the money will go directly to local authorities, but what happens to individual households? Some will have insurance cover, but I am sure the noble Lord will accept that many have not. Again, I should like some clarification of the position because there is nothing in the report on it.
	I want to reflect on the position of the Environment Agency. It was featured in a National Audit Office report published in June which noted that only 57 per cent of all flood risk asset systems and 46 per cent of other high-risk systems, such as those protecting urban areas, had achieved their target condition by March of this year, with the potential risk that a flood could occur. What is the Government's reaction to that, and what pressure have they put on the Environment Agency to put its house in order? I also understand that because of Defra's financial difficulties earlier in the year, cuts were made to the Environment Agency's budget. Perhaps the Minister can clarify how much those cuts were worth, and when or if they have been restored. I turn to the comments made by the noble Baroness, Lady Young, who said that the upgrading programme requires £1 billion each year. Can the Minister tell the House where this leaves us currently?
	Our deepest sympathy goes to all the affected businesses, individuals and families, many of whom are not in their own homes and will not be for many months. It is a dreadful situation. Floodwater is bad enough, but foul water is quite something else. My heart bleeds for those families because it is not a happy situation. Given that a Defra Minister is repeating the Statement, can he tell us what is the anticipated strategy for providing help to farmers in the affected areas? Many farms have been totally flooded with loss of livestock in addition to ruined crops. Has any thought been given to this issue? Within that, I want to mention the work of the Farming Help Partnership, a voluntary body offering help and support for families in need as quickly as it can.
	I come from the East Midlands region, which has not been quite as badly affected as the area around Tewkesbury and the West Midlands, but it has also been hit, particularly in Horncastle and Louth. When the earlier flooding occurred in Hull and north Yorkshire, why did Lincolnshire not receive any financial help when the other two areas did? I hope that in the allocation of moneys to local authorities, it will not be the case that some will be given money while others will get nothing. If no financial help is given to Lincolnshire this time, it will have been hit twice.
	Finally, I turn to the whole question of insurance cover. Many households have insurance cover for flooding, but a good number do not. Is the Minister in a position to tell the House how individual householders should go about seeking help? Will it come only from the Bellwin scheme or will the Government be making emergency money available to help them in the short term?
	I thank the Minister for repeating the Statement and for pointing out that unfortunately the situation is ongoing. Two aspects of it are particularly worrying: first, dirty water is all around and there are shortages of fresh water, which should be made available to all households; secondly, I understand that part of the electricity supply has already been lost and more may well be disrupted if the water cannot be pumped out of one of the substations. Those are my specific concerns.

Lord Dykes: My Lords, I, too, thank the Minister for repeating the Statement made by the Secretary of State for Environment, Food and Rural Affairs in another place, and I thank the noble Baroness, Lady Byford, for her remarks and questions. I agree with virtually everything she has said, and would particularly like to register from these Benches our profound sympathy for the families, companies, individuals and farmers who are suffering from this flooding. Everyone is going through an awful time in those localities. If we are spared this flooding disaster personally, it is easy just to read about it in the papers and leave it at that, but it is a horrendous personal problem for people and we feel very deeply about the situation. This is the fourth Statement in recent times on flooding problems. It is the first time that it has been repeated in the Lords and we particularly welcome that. This will inevitably be an ongoing matter.
	Obviously it sounds trite if one starts to criticise the Government for weather conditions—that would be most unfair; it is easier to criticise them for many of their domestic policies on a proper basis—but in this case we have to register our great concern about the ongoing problems which seem to be arising. The obvious climatic differences from previous occasions need to be looked at, but of real concern here is the way in which the Government have dealt with these things on past occasions. It gives me no pleasure to say this but it has to be said: is the Minister ready to deal seriously with these problems and what are the Government going to do in their review?
	It took the Government a long time to react to previous warnings, statements made by other people and ecological and weather experts in this country and elsewhere, and we can see the effects now in this country of the dire budget cuts that have taken place and the difficulties that they are causing to people. I have to say, again with regret, that the Government have failed to provide adequately for flood prevention, despite warnings. They were warned on a number of occasions that there would be serious flood risks in the north, particularly, and maybe elsewhere. This time the floods seem to be more in central and southern England. Our fellow citizens in the north suffered very grievously on an earlier occasion and are still suffering from it. Why did not the Government therefore make proper efforts to tackle these matters and to liaise with all the various agencies, including the Environment Agency, to ensure that there was proper co-ordination?
	We pay tribute to the community, voluntary and other organisations, and the Armed Forces, particularly, for what they have done in this recent emergency; it has been a magnificent effort. But the Government need to have forethought about these matters, and that was somewhat lacking on previous occasions. Despite the Government's promises two years ago to give the strategic overview of all flood risks to the Environment Agency, nothing has happened effectively. The responsibility for prevention and protection us against continued flooding remains split between councils, water companies and the Environment Agency, all of which operate on different scientific and quasi-scientific assessments of risk.
	I am sorry to say that the new Prime Minister must take some responsibility for the Government's flood failures as he cut the flood defence budget by £14 million last summer; and it was only last month that his previous department asked the agency and the local flood boards to plan for real effective cuts for the next three years. Even after the Yorkshire floods, the Treasury only reluctantly conceded that the defence budget for flooding should be boosted by 2010 while saying very little about the next two years of the spending plans. My noble friend Lady Miller of Chilthorne Domer asked a Private Notice Question on 27 June about the flooding, and that was the catalyst that caused the Government to respond.
	While we on these Benches feel disappointed, we thank the Government for the emergency measures they are taking now. We need further drastic action and much more reassurance from the Government in general. I should like a further update, if possible, from the Minister on the Ulley reservoir. What does he intend to do to provide immediate remedial action to help people, particularly those in danger of electricity cuts, to which the noble Baroness, Lady Byford, referred, and the danger of repeat flooding, about which experts have warned, in these areas during the coming days and weeks?

Lord Rooker: My Lords, I am grateful for the supportive comments from noble colleagues for the work of the emergency services and others; they are reflected by everyone. I shall do my best to answer the questions but let us get this clear: it is said in the Statement that the situation will get worse today and tomorrow as the rivers rise; anything I say could be overturned within an hour and so it is not possible to be specific. There are thousands of people out there working their socks off trying to protect the power stations, the transmission stations, and trying to pump out and get the water treatment plant working as soon as possible. Obviously that is vital. But, at the same time, the weather forecast is not good, the surge has not completely diminished and there are severe flood warnings on the Thames. So things can change dramatically. But I will give a commitment that Parliament will be updated. This is an awkward week, as it is the last one before Recess, but we will do our best to update.
	So far as the request for troops is concerned, the noble Baroness must appreciate that the Gold Command structure was set up long ago, and it was at Gold Command's request that the troops were called in. One has to leave it to the police, who are in overall charge of emergency services. The military liaison officers were present in Gold Command from the beginning, and obviously reacted when a request was made. I cannot be specific about the discussions that took place before that because I do not know, but that system is tried and tested and it works.
	I have to knock on the head again the allegations about the Environment Agency budget. The £14 million, out of the roughly £500 million budget, was nothing to do with defence work. That was last year's budget, and it was replaced in this year's budget with even more money. That was not a capital programme. No flood defence work was stopped for it. The capital programme—£600 million, from memory—is more than what it was eight or nine years ago, when it was £200 million or so. We have said we will put it up to £800 million. The noble Baroness put that in with the Bellwin rules, but it is nothing to do with those figures; it is the capital flood defence programme that we have already announced for Environment Agency work.
	The Bellwin rules were that 85 per cent of the extra expenditure necessary for local authorities is provided. That has been changed to 100 per cent, as the Prime Minister said over the weekend. I cannot be specific about the money that local authorities will get, but clearly we have to review their funding, as was said following the floods in the north when extra money, over and above Bellwin, was made available. The reduction in the Environment Agency budget was for some repair work, but I emphasise that it was £14 million. It would not have made the slightest difference to the current situation, and it was not part of the capital programme for flood defences, which was not cut; indeed, it has been increased over the period of this Government.
	Last week, on a visit, the Secretary of State said that he would relax the cross-compliance rules for farmers on request for those who needed to use, for example, set-aside land. We will be actively looking at considering that in relation to the whole of England and will consider how the regulations work and whether there should be any other necessary relaxations to assist farmers. One cannot tell at present what is needed. We know what crops were in the fields and it is true that many will be devastated, some more than others. We will do our best to help farmers, who are very practical people in any event.
	I was asked about the co-ordination of flood emergencies. They are co-ordinated, as are other emergencies, by Gold and Silver commands, led by the police. That system works well. The Government have set out a strategic overview role for the Environment Agency. We have the stated procedures, which we will be reviewing. There is no doubt that there are lessons to be learnt from the past there days, as from three weeks ago.
	I regret that I cannot say anything about families and insurance. It is far too early for me to say anything about what has happened in the past three days in that respect. I understand that, in the area that has been flooded in central England, fewer properties have been affected than in the north a few weeks ago and that there is a greater propensity for properties to be insured in that part of the world. I do not have specific figures. I saw some graphs and charts early this morning, but it is too early to say at present.
	The floods in central England are, by current calculations, worse than those in 1947. What is more, in 1947 they came in winter when one expects flooding, with the rain and the snow off the hills. Here we are in the middle of summer, when one cannot reasonably expect all this. This was not rain coming off the Welsh hills down into the Severn; it was six and a half inches of rain dropping across central England. London got a taste of it on Friday, but that was nothing like what fell on the rest of the country.
	As for warnings, I fully accept what the noble Lord, Lord Dykes, said, but I can remember standing at this Dispatch Box a few months ago, giving a report about the fact that we had had no rain in April. I was assuring the House that the reservoirs and aquifers were full and that we did not foresee having standpipes. I was got at in the Corridor outside by noble Lords saying, "You've really put your head on the block there, sonny. Are you really sure we'll have enough water?". Some of the forecasts were of a long, dry, hot summer. With no rain in April, we were thinking there would be serious trouble—and then we end up with the wettest June on record. I fully admit that all kinds of warnings have been given, but with what happened on Friday, no warnings and no amount of work following them would have assisted. I understand that the barrier at Upton upon Severn could not get there; if it had been there, it would have been overwhelmed this time, unlike the last time it was used. I appreciate that that is no comfort to the people in Upton upon Severn.
	I mentioned Lincolnshire in the list of counties and we accept that it has been affected. It would be unfair if a county was caught twice and missed out twice; we will take that factor into account.
	I am not in a position to go into detail about the National Audit Office report. It was a follow up to the one in 2001; it was checking, and the Public Accounts Committee took advice from the noble Baroness and others. I think that it has yet to report.
	The key aspects of the emergency are supplies of clean water and electricity. Your house being flooded is one thing, but no water—in the taps, for the toilets, to wash with—and no electricity is serious. This is of the utmost importance. In the mean time, the companies are supplying water to locations which everyone will know.
	I reinforce what was said in the Statement. People should first contact the Environment Agency's Floodline and, above all, they should listen to their local radio station. National radio stations are no use for local information. I was caught on Friday, like a lot of others, and Radio Oxford and Radio Gloucestershire gave me, and all the thousands I was stuck with, massive amounts of good, practical information. That is used by the police to feed information to people so that they can react. People should look in on neighbours they may not have seen, help out with the water situation and give comfort. If the electricity is off, they should make sure that before it is switched on again, things are safe.
	There is an emergency out there as I speak, and I regret that I cannot be more informative.

Lord Crickhowell: My Lords, I intervene as a former chairman of the National Rivers Authority, the predecessor body to the Environment Agency. As there are photographs of Tewkesbury in practically every newspaper today, I might add that I was married in Tewkesbury Abbey to a Tewkesbury girl.
	I join those who have expressed sympathy for everyone who has suffered the appalling disaster of having their homes flooded. But in my view, it is very unwise, even for—perhaps especially for—Members of Parliament rushing to score brownie points with their constituents to criticise public bodies such as the Environment Agency without knowing all the facts. Having had to deal with situations during my time, although not quite as bad as this, I offer my congratulations to the Environment Agency on the sometimes heroic work that it has carried out and the conscientious way in which it has done so. While we may, when we examine its record, find that some mistakes were made, I think its overall performance has been entirely to its credit.
	My noble friend Lady Byford spoke about the condition of assets and asked what pressure had been put on the Environment Agency to put its house in order. I am afraid that I would put the question rather differently: what pressure has been put on the Government to put their house in order in funding the Environment Agency, not on the capital budget, to which the noble Lord referred in some detail, but on the maintenance budget? My understanding is that the Environment Agency pressed hard for additional funding for the maintenance of existing facilities.
	When people look at the performance of the Environment Agency, they are understandably unaware of the many areas where flooding has been avoided because of the work that has been carried out in constructing schemes. I cite, for example, the Thames, where flooding would have been much worse but for the construction of the project there.
	Probably the most important single lesson to come out of this is that you must build neither housing nor infrastructure in the flood plain. That is primarily what we suffering from; we will have more flooding of this kind until that lesson is learnt. As I am being urged to sit down at this point, I may rise to press that point again when we come to the housing Statement that will follow.

Lord Rooker: My Lords, I pay tribute to the work of the noble Lord, Lord Crickhowell, because I can remember when he left the other place to chair the National Rivers Authority. He is quite right that it is unwise to hurry criticism. Plenty of people can be subject to criticism in due course, after we have had a mature look at what has happened. I reinforce his tribute to the water engineers and the electrical engineers, who have worked their socks off anyway, particularly in emergencies. They are the people on whom we rely and they are doing a very good job.
	The noble Lord mentioned the maintenance budget. To the best of my knowledge, flooding in less than 1 per cent of areas is as a result of a structural failure of flood defences. Even the NAO found that the flood defences that are in place are maintained to a very high level. There has been structural failure in only about 1 per cent of flooded areas. Those defences in place have worked extremely well, although I accept that there are not enough of them.

The Lord Bishop of Sheffield: My Lords, I, too, thank the Minister for his Statement. The right reverend Prelate the Bishop of Worcester, who is sitting beside me, and I are between us responsible for a fair amount of the flooding, so some people would like to think. However, they happen in our patch. I therefore pay tribute particularly to the others who are not often named. If it were not for volunteers, our society would collapse at times like this. I think of St John Ambulance, the Salvation Army, the Red Cross and so on. It is important that tribute be paid to them, who are helping at this very moment. I have just come from the headquarters of the St John Ambulance and there is hardly anybody there, because they have all shot off to do what they can.
	Perhaps I may make a point from three weeks' experience of the flooding. We are beginning to pick up some of the pieces in Sheffield and look towards what might happen in the future. On Friday evening of this week, it will be the Forfeit Feast in Sheffield, where the Master Cutler hosts a reception and a great feast for the Lord Mayor of London and others. The Master Cutler has a small business, built in the flood plain, but several feet above the record level of any flood damage in the history of Sheffield. He has lost in his small business all his 150 motors, which have to be dismantled and dried out. He does not know when he will get back in business; the likelihood is that he will not. Therefore, his small business and many others will go under. Sheffield Forgemasters has lost £20 million already through lost business. Coupled with the strength of the pound many manufacturers in our part of the world will perhaps be permanently damaged by what has happened in the past few weeks. It is my hope that, in these emergencies, the Government will think well enough in advance about what might happen.

Lord Evans of Temple Guiting: My Lords, before we go any further, perhaps I may remind noble Lords that the Companion tells us:
	"Ministerial statements are made for the information of the House, and although brief comments and questions from all quarters of the House are allowed, statements should not be made the occasion for an immediate debate".
	I make that point because I think that a considerable number of Peers would like to make a contribution.

Lord Rooker: My Lords, I am grateful to the right reverend Prelate for emphasising the work of the third sector and others who are not part of the third sector but are just good neighbours. Half of Gloucestershire turned up on Friday night, well past midnight, at the school—I cannot remember its name—at Junction 9 of the M5. It had all its doors open and people were bringing clothes and bedding; there were not many chairs but the place was warm and dry. The motorway was jammed and it was dark, so you could not see what was happening. But there has been a massive contribution from the sectors. I cannot comment on businesses. Some of them are insured and some are not; some will be covered and some will not; some of them have past experience and some have not. These issues must be reviewed and we must learn the lessons.

Lord Faulkner of Worcester: My Lords, I shall follow the injunction of my noble friend Lord Evans of Temple Guiting. I declare an interest as a resident of the city of Worcester and a member of Worcestershire County Cricket Club, which will sadly not be playing again at Worcester this season.
	I have two points. First, will the Minister extend his very welcome comments about the devotion of the emergency services to those public servants such as the employees of county councils, who have worked almost without break for the whole weekend? I have heard accounts this afternoon of county council employees working for 36 hours continuously to deal with the crisis in Worcestershire and of the staff of a special school who stayed with their pupils through the night because there was no other way in which to look after them.
	When we come to review the lessons from this awful weekend, could somebody please look at the flood defences on the River Severn, particularly upstream? This is not the first time that the Severn has flooded and it is certainly not the first time that Worcestershire cricket ground has flooded, but it is the first time that we have had anything on the scale that we have seen over this weekend. Could some form of permanent barrier be put in place to deal with this sort of situation in future?

Lord Rooker: My Lords, I am grateful to my noble friend for emphasising the work of local government staff. It is true that local government probably knows more about its areas than any other body—although, when one flies over those areas or looks at the pictures in the papers, one cannot quite see the boundaries of one authority and another because it is all covered in water. But it is true—people did not go home but stayed at their posts over the weekend to do their public duty. If there is an interest to be declared in this regard, I should say that I pay my council tax to Tewkesbury Borough Council.

Baroness O'Cathain: My Lords, has anything been done to get huge supplies of bottled water to the area? That was not mentioned in the Statement, but there was a report on the radio this morning that none of the supermarkets or the other shops in the area had any supplies of bottled water and that all their supplies had been, if not purloined, then taken up. I thought it very ironic, when I walked past Westminster Tube station and alongside Tesco, to see that there were whole windows of bottled water. Has something been done about transferring supplies to that area?

Lord Rooker: My Lords, I shall check on this for the noble Baroness, but nobody has indicated any shortage of supply of bottled water. Shops may have run out, but I refer to water authorities getting water to the areas. What is in the supermarkets is a different issue. The bowsers will be filled by the tankers, and there are supplies from the water authorities, as I understand it.

Viscount Montgomery of Alamein: My Lords, if the flooding continues, the Thames estuary will become vulnerable if there is a particularly high spring tide. Has any work been done on anticipating that, apart from listening to local radio?

Lord Rooker: My Lords, I am just hoping that the barrier will work, as it is the one flood defence that we have. It is old and it is sinking and it does more work than was planned, so we must look at that for the future. The noble Viscount is quite right: the Thames is going to rise. The surge of the Thames at various locations is yet to come.

Local Government and Public Involvement in Health Bill

Baroness Andrews: My Lords, I beg to move that the House do now again resolve itself into Committee on this Bill.

Moved accordingly, and, on Question, Motion agreed to.
	House in Committee accordingly.
	[The DEPUTY CHAIRMAN OF COMMITTEES (Lord Allenby of Megiddo) in the Chair.]
	Clause 222 [Health services and social services: local involvement networks]:

Earl Howe: moved Amendment No. 238KBA:
	Clause 222, page 154, line 29, leave out from beginning to "specified" and insert ", establishing and supporting Local Involvement Networks to perform the functions"

Earl Howe: I shall speak also to Amendments Nos. 238KBB, 238KCA and 238LF.The Minister may be glad to have reached Part 14 of the Bill, if only because the end of her marathon stint in Committee is in sight. I would also not be surprised if she were to view the change of subject matter as a welcome shift of focus. From these Benches, we look forward to a constructive debate on patient and public involvement, although these matters arouse considerable concerns and difficulties in the minds of many of us. I am sure that she will, in her customarily helpful way, do her best to try to reassure us, but I suspect that in some cases that will not be easy or straightforward.
	I start with a group of amendments designed to pose a simple question. The Minister will know from our debate at Second Reading that, in the eyes of many of us, the over-riding defect of this part of the Bill is that it appears to have been put together by a cryptologist. From reading it, it is impossible to decipher what on Earth it all means. The Minister clearly knows what it means and we may think we know as a result of all the background material and Explanatory Notes.
	As a starting point, it is worth asking this very simple question: should not part of the aim of all legislation, including this Bill, be to be comprehensible in its own right? We understand that, arising from the Bill, there will be new bodies called local involvement networks or LINks. It is understood that the function of LINks will be analogous to that of patient forums, except that the LINks will extend to social care. Certain members of LINks will be authorised to perform certain functions. While the exact form and membership of LINks will be up to local determination and, therefore, are not to be laid down in the Bill, we can safely say that LINks will, at least, have members.
	But when we read the Bill, what do we find? We find that we are led around in a kind of dance, the aim of which is to go to fantastic lengths to avoid making any sort of descriptive reference to local involvement networks, to avoid any mention of their functions or powers and to omit all reference whatever to the fact that they are supposed to have members. Instead, in Clause 222 we have "arrangements", along with "activities". We do not have members of LINks; we have people. LINks are not even given any powers. The powers of LINks are only visible, as it were, in the mirror because they take the form of other people having duties in relation to LINks. Indeed, LINks are not bodies at all. The only clue as to what a LINk is comes in Clause 223(2), where we are told:
	"In this section, a reference to a 'local involvement network' is to a person".
	That reference to a person is the nearest we ever get to a definition of a LINk in the Bill. But who on Earth refers to a network as a person? A "person" is not a word that makes any sense in this context at all; it may make sense to a lawyer, but who in the ordinary world can understand it? I do not think that any of this language is helpful. I ask the Minister why we have this rigmarole. Why can we not have, as the amendments propose, a definition of a LINk, however loose, on the face of the Bill, together with clear statements about its functions?
	There is a serious point here about accountability. Many of us will have seen the press report last week telling us that the Government intend to reduce the number of central targets for the health service and to make local bodies responsible for setting their own targets. That is fine, but what follows is more local accountability, and patient and public involvement in the planning and delivery of healthcare is a terribly important part of what we mean by local accountability.
	What are the mechanisms for delivering it? As far as I can make out, it is not even going to be a contract. The arrangements referred to in Clause 222 are arrangements not with a LINk but with somebody else—namely, a host organisation. If the mechanisms for delivering patient and public involvement do not include having independent statutory bodies with defined functions, and if LINks themselves are not subject to a contract, how can we truly say that we are setting up a system that delivers robust local accountability? I believe that it is very difficult.
	In her letter of 9 July, the Minister confirmed that we cannot prejudge what LINks will look like. As with a creature from Lewis Carroll, we may know a LINk when we see it, but we cannot, for the moment, define one. Whatever LINks seem to be, we see from the Bill that they will not have functions. If we cannot define a LINk and it does not have functions, the obvious questions arise. How will it be able to enforce its rights in law and, from the opposite perspective, how will people be able to enforce a complaint against a LINk about what it is or is not doing, and on what legal basis?
	I do not know whether the Minister can give us any satisfactory answers to all that. The point is not just that the Bill is vague but that it does not appear to deliver a sound basis for what most of us think patient and public involvement should truly be. I beg to move.

Baroness Neuberger: I support very strongly the words of the noble Earl, Lord Howe. Since I think that we agree on everything, I just want to add a little more weight to what he has said. Perhaps it is good for the Minister to hear that, across the Cross Benches, the Conservative Benches, the Lib Dem Benches and some of the Labour Benches, we are united in some of our concerns about this part of the Bill.
	When we first saw the Bill, many of us were deeply concerned because we could not find any clarity in it; we could not work out what it really meant. However, as the weeks have passed, we have learnt more about, for instance, what the early adopters of the LINk model were doing. I was truly shocked that they were given a set of objectives that asked them to focus on particular aspects—this is from evidence that was given by Meredith Vivian to the Health Select Committee—without a clear list of duties.
	So much of it, in everything that we could find, was process driven. It was all about,
	"how we can make sure we reach as many people as possible and are as engaged as possible with voluntary community sectors, how we can make sure that what we do is well-known in terms of communication and visibility".
	But what the objectives are remains, to most of us, singularly unclear.
	It is not just me saying that. The Health Select Committee, in its report, said:
	"The 'early adopter' projects appear less an objective trial than a discussion with stakeholders, and a key point—what can be expected from Hosts—is not being addressed".
	It went on to recommend full trials of LINks to assess the practical requirements for running them. Indeed, it listed evidence from Elizabeth Manero of Health Link, suggesting that a model for LINks would be the best practices of the patient forums, where a core group will perhaps run the LINk,
	"make decisions about the LINks activities, can sit in on trusts' boards and meetings, and undertake surveys or visits. They produce reports and challenge trusts if they are unhappy with the response".
	She added:
	"They would also do everything they could to connect with local groups and find out a wider public view".
	Her worry about LINks, as presently imagined, was that,
	"the proposal is to have a very, very large, 'perhaps thousands of people', involved in the Health Service".
	She continued that she was worried that this focused on a process rather than on refining an outcome.
	I already had real concerns about all this, as did many members of forums who have contacted me separately and together in the past few weeks. But my concerns have been strengthened considerably during the past week. The Minister kindly sent all of us involved in the Second Reading debate the drafts of two guidance documents for the establishment of LINks. The first was the model contract specification and the second was a document that sets out,
	"what we expect an effective LINk would look like, based on what we have learned so far from the work of the Early Adopter Project sites, as well as from other networks in the community".
	I am grateful to the Minister for sending us this material, but the second document made me almost lose the will to live. It is, indeed, all about process—what it will be like—including a rather offensive list of what it will not be like. The document states:
	"A LINk is not ... a group of volunteers who are solely responsible for inspecting NHS and social care premises and services ... a method of performance managing health and social care services ... a method of dealing with individual complaints about local care services ... a network that duplicates other networks and initiatives",
	and so on. That list is, rather, a suggestion that forums have not lived up to expectations and that they are somewhat like these theoretical groups that LINks are not to be.
	The real clue lies in the statement that the detail of the powers of LINks will be provided in the future regulations that the Government intend to consult on in the autumn. There is no clarity, just the suggestion that,
	"LINks have a role in ... promoting and supporting the involvement of people in the commissioning, provision and scrutiny of local health and social care services ... obtaining the views of people about their need for, and experiences of, local health and social care services ... enabling people to monitor and review the commissioning and provision of care services ... making their views known to the people responsible for commissioning, providing, managing and scrutinising those services".
	We are then told:
	"This will be achieved by establishing a flexible framework, which can be tailored in each area",
	according to local circumstances. There follows a series of diagrams from early adopters—Kensington and Chelsea, and Durham. While I could understand Kensington and Chelsea's simple membership diagram and begin to comprehend its more complicated model of how it would work with no central hub membership, the Durham model left me wholly baffled. In each case, the text tells us that the models are under development. I am not surprised. This way of thinking is absurd. The first decision must be about the objectives, powers and duties of LINks. What are they to do? What must they do? What can they do? Only then should this discussion of process even begin.
	This has seemed to me to show that the Department of Health is more concerned with process in this area than outcome and is more concerned with breaking down the present structure of patient forums than developing them and creating a smooth transition into LINks. It is not concerned about creating a huge cadre of disaffected volunteers, who will look at all this and ask, quite sensibly, what it really means. For those reasons and many others, I strongly support this group of amendments.

Lord Low of Dalston: I, too, support this group of amendments, particularly Amendment No. 238LF. I received an e-mail about the Bill at the weekend, which pointed out that as things stand, since local involvement networks have no independent legal personality, their members could be personally liable for their actions, even though they are discharging statutory functions. This contrasts sharply with the present position whereby patients' forums are legal entities.
	Amendment No. 238LF changes the definition of a LINk in Clause 223(2) from a person carrying on the activities specified in Clause 222(2) to,
	"a body set up in pursuance of the arrangements specified in",
	Clause 222(1). The amendment, therefore, would change LINks from groups of persons coalescing around a particular function or set of functions to a corporate legal entity. I submit that this is a much more satisfactory situation for the members of these local involvement networks and I believe, therefore, that this constitutes an ungainsayable argument for inserting Amendment No. 238LF into the Bill.

Baroness Howe of Idlicote: I, too, would like to support the making of a LINk, if we are to have LINks in the way that has been suggested by the noble Earl, Lord Howe, and re-emphasised by my noble friend Lord Low. What really concerns us is that we have no real conception of what the future holds. The noble Baroness, Lady Neuberger, has spelt it out extremely well.
	I have to admit that I have another worry. It seems extraordinary that this Bill has been going on for so long now in the background without coming to Parliament. The Commission for Patient and Public Involvement in Health has been extended about nine times since it began. That is a fairly extraordinary figure. We have heard from some of the earlier doctors that very good work has been going on with more or less the same members as exist in the forum. I find it really rather upsetting that, even if the time has come to say goodbye finally to the Commission for Patient and Public Involvement in Health, nobody has thanked it for the work that it has done. Considering it was set up and abolished almost at once, it was a pretty disturbing commission to have been in charge of and to have been on the staff of. I would like the Minister to take this opportunity to say something rather more positive than we have heard so far.
	There are obviously reasons for moving in this direction, particularly on the social care side, as I understand it, which cannot so easily be joined with the health side. I believe that the health side is rather bossy and dominant. It will take some persuading that we will have a sufficiently strong social care side for them to be on a par and in partnership; many other Bills put through by the Government rightly aimed to achieve partnerships at all social levels. I just wanted to say that, by way of a background to my concerns. I did not take part at Second Reading because of other commitments later in the day but I was there for most of the time and I have followed, as far as I can, what has been going on since.

Baroness Masham of Ilton: The House of Commons Select Committee on Health called LINks woolly. What Members of this House have said today bears out what they felt. Members of health forums have been treated very badly. These are volunteers. They need support, not putting down. Will members of LINks be treated any better? We need good public involvement in health. I hope that the Minister will comment on that.

Baroness Howarth of Breckland: I want to ask one or two questions. I apologise for not being able to take part on Second Reading. I, too, am bemused about this but could not have put the position more eruditely than did the noble Earl, Lord Howe; it is always a joy to listen to him but this afternoon was a particular joy.
	My questions are about how ordinary people who will become part of LINks—or at least those whom the Government hope will become part of LINks—will understand what they are engaging in. I say that having talked to some ordinary folk who regretted the loss of their community health councils, but continued stalwartly to join patient forums—I declare an interest as a rather distant member of the St Thomas's forum—and would like to continue to work in these areas. They do not understand two things, the first of which is about governance. How do these strange bodies, which are so ill defined, fit into the total governance structure of the health service? Do they have any power? Are they just sounding boards? What is their value? How will they be appreciated and understood? How will you get that message to ordinary people to maintain their interest?
	Secondly, because of all this, I do not really understand what the objective is for the new groups. That may be my lack because I was not able to engage in Second Reading or listen to all of it, although I read a certain amount. I understood the community health councils; the Government may not have liked what some of those groups did in terms of challenging issues in the health service. I have begun to understand—just about—what the patient forums were doing. I cannot understand what LINks are going to do. I am afraid that, even after listening very carefully to the noble Earl, Lord Howe, who usually illuminates me, I still do not understand—probably because he does not know either—what the organisations, bodies or people will do. I would be grateful for clarification from the Minister. A great deal depends on this in relation to local involvement, particularly, as my noble friend Lady Howe said, if we are to try to engage people in understanding LINks in relation to social care, with which I have a strong connection. It would be a great help if local communities could understand LINks. If they cannot understand the structures, they will never understand the services.

Baroness Andrews: I am tempted to welcome this new cast to Part 14 of the Bill. We have had a splendid time so far but we have an even better time in prospect.
	I am challenged by the "enigma code" version of the Bill proposed by the noble Earl. I am happy to do what I can to decrypt the Bill. I hope to inspire noble Lords to have confidence in where we are and why we are there. We give additional information in the hope of clarifying and supporting people's understanding. Given what has been said, it might be useful if I give a bit of background about why we have come up with this formulation.
	The amendments explore our changes and why we made them, the relation between the host and the LINk and the form and function of what is planned. Those issues go to the heart of what we are trying to do. I understand what noble Lords are saying about the absence of a statement of objectives at the front of the Bill. We have that debate over and over again in the House; we had it recently on mental health.
	I refer noble Lords to the Minister's foreword to Creating an Effective LINk, a draft document which has been circulated. It can be summed up very simply: the establishment of local involvement networks gives communities the chance to influence all health and social care services. Whether they are run by councils or the NHS, LINks will give citizens the chance to have their say in a much wider range of ways, which I will come to discuss later. It may be, for example, by investigation or commissioning reports that will be put together by a much wider range of participants than has ever been possible before, because of the extension to social care. It may be through the "enter and view" function, which is very clear in the Bill. It could be by gathering voices to exert greater influence on a particular decision in the local health service.
	Part 14 is not a convenient afterthought; it is brought forward from a genuine conviction that there must be better and less exclusive and forbidding ways for people to exert influence over health and social care in all areas of communities and to become more involved in what matters most to them. The substance of Part 14 is to put forward those more extensive and inclusive ways of involving the widest range of people to influence and improve healthcare. This debate has a long history; noble Lords around the Chamber will have engaged in it.
	I know that change is not comfortable; neither is acknowledging that what served once has been overtaken by different imperatives, but that is part of the debate that we are having. The first thing that I want to say, particularly to the noble Baronesses, Lady Masham and Lady Howe, is that I thank those who have served on patients' forums for their work. The Minister thanks them in the foreword to the document; they have been thanked in different ways. Without their expertise and commitment, which have been built up and demonstrated, we would have a far worse health service. They have performed an extremely important function, so much so that we are determined that that expertise will not be lost, devalued or wasted. As I explained, as we go through the amendments, we want passionately to build on the best of what has been achieved and, indeed, to extend it.
	It is important to stress that these requirements are in this Bill because they belong here. First, their new role in local government will go far beyond the notion of a traditional delivery service, taking local authorities to the threshold of a new role in which they will shape the whole local environment—the place in which people live, work and thrive. In terms of health, that is expressed first in the new duty that we propose for local authorities to put in place an independent structure to empower local people. Secondly, the Bill will enable services to work together in ways that have eluded us so far, closing gaps between social care and health in the design and delivery of services. Thirdly, the Bill breaks new ground in healthcare by finding a way to involve local people in providing services that go far beyond the interrogation of institutions, which is what the patients' forum specialised in. They therefore go beyond the expertise of a small and dedicated group. The Bill goes into the wider community, across the entire patient journey and the experiences people have as part of that long journey.
	I know that noble Lords are asking, "Why this Bill?" and "Why now?". In the past five years, the landscape of healthcare has changed, and it continues to change. The institutions have changed; foundation trusts and primary care trusts have changed; the configuration of PCTs and the patterns of provision have changed. Healthcare is offered in different ways and places. Priorities have changed; people have changed. Patients have become far more used to choice and far more used to being heard. System regulation has become more sophisticated. We have the wherewithal, capacity and vision to join up services. The health service role of overview and scrutiny committees has changed. I could go on.
	Just as the system for health and social care has changed, the opportunities must change so that local people can shape the services that they experience. I am not saying that patients' forums failed, but the context and demands on services changed and the remit of the patients' forums was narrow: they covered only health; they focused on institutions; they were very inflexible; and they were inextricably linked in legislation with the Commission for Patient and Public Involvement in Health. That was determined centrally, so what they did and how they were made up, supported and funded was all set out in legislation. That is why we have come forward with a proposal which, I believe, provides the security of a legal framework and guarantees that an independent organisation—a host—will have a way of collecting and amplifying the voices of people who might otherwise not be heard.
	At all levels of the system we have built in accountability between the local authority and the host in terms of the contract—the host is the servant of LINks, much as officials serve Ministers—and between LINks themselves and the wider community. I am sure that we will explore that in due course.
	For very good reason, we have not put in the Bill details about the form that a LINk might take, although its functions are set out clearly in Clause 222. We have not included those details because that ties in with the culture of the change that we are trying to make and because in the consultation that preceded the Bill it was made clear that local people wanted to decide the form of the organisation and to determine the scope of the network and its membership and governance arrangements.
	Amendments Nos. 238KBB, 238KCA and 238LF would put a duty on the local authority to establish a LINk directly rather than through the procurement of a host. Having set out the context, I hope that the Committee will recognise that I appreciate the sentiment behind that aim and the fact that noble Lords are searching for an explanation of this structure. I also fully appreciate the difficulties that can be brought about by a lack of detail in the Bill. Many Bills are icebergs: all the interesting stuff is underneath and the legislation has to be interpreted in different ways. I can see the attraction of putting in a definition of an organisation with legal substance and form; apart from anything else, it would seem to give noble Lords a degree of security that a tangible organisation would emerge. However, I stress that, in not doing that, we are not being perverse; we propose that a LINk should be created as a result of a contractual arrangement not so as to weaken, lessen the impact of or sideline a LINk and not because we think that it is a better philosophical model. Above all, we are taking this approach because, given the new relationship between a local authority and a local area, we need a means of ensuring that the LINk is separate from the local authority.
	A fundamental premise of patient and public involvement is that arrangements must be independent. I can understand the desire to simplify arrangements by cutting out the need for a host, but the host will perform a critical function: it will support independence. Without that arm's-length body holding the budget, facilitating the early stages of forming the network—I shall come later to the point raised by the noble Baroness, Lady Howarth—and enabling LINk members to generate a common agenda and distinguish priorities, the LINk might become no more than a reflection of or extension of the local authority. These amendments would reverse that principle by creating a LINk which, I fear, could become a creature of a local authority. That is why we are trying to build in independence.
	Perhaps I may write to the noble Lord, Lord Low, on his question about the limited liability company. That was an interesting point, but I cannot answer it from the Dispatch Box.
	The noble Earl, Lord Howe, asked why there was not more substance, with more detail about form and functions, in the Bill. The noble Baroness, Lady Neuberger, said that it is all about process. I hope that I have set out the reasons why the objectives are clear. The process is there to deliver objectives, and we are doing this to expand opportunities for people to have a greater say over their health and care. I was asked why, for example, we cannot substitute the word "functions" for "activities" in the Bill. They are described as activities because they allow a LINk to have some discretion, whereas "functions" suggests that they would be mandatory. We refer to people in the Bill, rather than to LINks themselves, because LINks are collections of people—collectives, in a way. A LINk has no set definition; we will talk about that in a moment. The legislation does not describe what LINks should do, because we want them to make their own judgments about what is more important for their areas.
	In framing the legislation, we have tried to reflect the need for flexibility and autonomy. I understand the frustration, but this is a better way forward. The noble Baroness, Lady Neuberger, referred to two of the three diagrams at the back of the report; one is definitely more complicated than the other, but that has been a local choice. Sometimes democracy is complicated and diverse; indeed, I can tell the noble Baroness, Lady Masham, that it is sometimes very worrying. Yet if we give people the power to choose what to prioritise, they will come up with some hard choices that will challenge the local health and care services.
	There are different models in development. One LINk could have a host that provides all the staffing and support that we could think of, while another may say, "No, just hold our funds. We want to employ our own staff", and it will be able to do that. In either case, the network of participants will decide. One reason for this determination is that we did not want to repeat past mistakes. Over the past few years, officials at the DoH have received countless requests for clarification about the legislation surrounding PPI forums—whether they can do this or that. Usually, the answer has been no because the legislation has not allowed them to. We wanted to avoid that so, for now, abstract and enigmatic though it may be, we are providing the chance for LINks to be created in ways that are relevant to people and places.
	I will briefly flesh out the bones before I finish. LINks will create coherent arrangements for governance, more likely comprising a small group of people and user organisations as their heart and soul. LINks will have a clear identity, with known contact points. Once it is contracted, the host will first map out who is liable to want to join in the area—some local authorities have already begun that process. As well as the usual organisations, such as self-help groups and so on, there could be youth organisations, for example, because there are issues regarding youth health. LINks will be able to relate directly to NHS and social care organisations and to enter and view premises. Noble Lords will see that in Clause 225. LINks will be able to request information, to make reports and recommendations, and to receive a response. Critically, they will be able to refer matters of concern to the relevant overview and scrutiny committee. These important powers and functions are clearly laid out, and we think that they score highly on those grounds.
	I hope that I have been able to provide some reassurance. Clearly, it is a starting point for the rest of our debates on the detail. I hope that noble Lords will feel that the objectives are clear, that the process is necessary and that we have laid out as much as is possible of what we expect in the Bill.

Earl Howe: The noble Baroness has made a brave attempt to respond to the points made in this extremely interesting debate, but I am afraid that I remain pretty unconvinced that we have anything comprehensible here. In these amendments, I was trying to pin down a sense of what legal identity, if any, LINks would have. I am puzzled by that because while the Bill tells us that a local involvement network is a person, we are told that it cannot be a statutory body. It seems an odd contradiction to state in the Bill that a LINk is a person while we are told that it has no legal identity. Can the Minister clarify that, before we go further?

Baroness Andrews: As I understand it, the contractual legal arrangement is that exemplified in the contract held between the local authority and the host. The LINks themselves are networks, rather like local strategic partnerships; they are arrangements of local people taking part and coming together for different purposes, without having a formal or fixed legal structure.

Earl Howe: All this is very strange. I should have thought that that would indicate that a LINk could not therefore be a person. No doubt we will have time to resolve these matters.

Lord Wedderburn of Charlton: A trade union is not in law a person but by statute has the capacity to make contracts.

Earl Howe: I thank the noble Lord for that very interesting and illuminating observation. I will have to see how relevant it is to the Bill; I am not quick enough to know whether it is.
	The vagueness in the wording of this part of the Bill is in danger of letting down the Government. Let us look at the word "activities". It struck me on reading this that there may be nothing to prevent more than one LINk in a local authority area. It would be possible, for example, for a host to support several bodies calling themselves LINks in a particular area, rather than just one. I do not think that is what the Government have in mind. It would be extremely undesirable and confusing to have more than one LINk in a local authority area. The Bill appears to allow for it. Do the Government want to rule out that possibility? If so, why does the Bill not do so?

Baroness Andrews: That is an interesting point. I am fairly certain that, by definition, we do not want to see more than one LINk because the area should be coterminous with the local area. We certainly will look at any element of drafting that we need to.
	On the legal point, like all voluntary organisations it is possible for a LINk to form itself into a company limited by guarantee, and even in due course to set itself up as a charity. Therefore it can have a legal status, rather than just being a completely amorphous collection of people. That goes some way in identifying the legal profile.

Earl Howe: I am grateful to the noble Baroness, and, indeed, I picked up from her remarks that a LINk can have a legal identity in that sense. What I was trying to get closer to is whether it has a statutory identity.
	I confess I was puzzled by some of the other things the noble Baroness said. She said that if we try to include functions in the Bill, the language of functions would mean that whatever we included in the Bill would be mandatory. I am not sure that that is a show-stopper. If we believe that these bodies should have functions then why should we not say so? We need to reflect carefully on that.
	The point about accountability and powers is a key part of all this. If an organisation has no powers conferred on it in statute, and not even any direct contractual obligations, it is very difficult to see how it can be part of a chain of accountability for local public services. It will amount to being no more than a talking shop. That is what some of us suspect LINks may turn into. A suspicious mind before this debate might have believed that that is what the Government were hoping to set up by means of the Bill, but I take the noble Baroness's word that it is not.
	The Minister has indicated that the department has been in receipt of representations about the shortcomings of patients' forums. I do not doubt that, but I am tempted to reflect on the question of whose legislation it was that set up the forums in the first place. I think that we all know the answer to that. It is time to move on after nearly 45 minutes, and I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.
	[Amendment No. 238KBB not moved.]

Baroness Morgan of Drefelin: I beg to move that the House do now resume.

Moved accordingly, and, on Question, Motion agreed to.
	House resumed.

Housing

Baroness Andrews: My Lords, with the leave of the House, I shall now make a Statement about housing supply. The Statement is as follows:
	"I start by supporting the Statement of my right honourable friend and joining the many members of the House who have expressed their sympathy to the thousands of families whose lives have been turned upside down by the unprecedented flooding affecting wide parts of the country."The Government is publishing today its housing Green Paper, setting out proposals to deliver the homes Britain urgently needs today and for the future. "The House should be proud of the huge steps this country has taken since 1997—a two-thirds cut in rough sleeping; £20 billion investment in social housing that has helped lift over a million children out of cold or poor conditions; and economic stability that has given over one million more people the opportunity to become homeowners. But we also need to respond to new challenges. Demand for homes to buy or rent is growing faster than supply, and homes are becoming less affordable as a result. Already many first-time buyers rely on the help of friends or family to get a foot on the ladder. It simply is not fair that your chance of owning your home should depend so much on whether your parents or grandparents did before you. Nor is it fair that children are growing up in overcrowded or temporary accommodation, waiting for a settled home. Without further action, housing could become one of the greatest sources of social inequality in the next 20 years. "In addition, we need to respond to the challenge of climate change. Our homes account for more than a quarter of national carbon emissions. We must provide greener, better designed housing for the future. As recent events have highlighted, it is absolutely vital to take steps to protect all our communities from flooding, and from the consequences of climate change in future. In the face of these three challenges, we propose strong action."First, we will build more homes to meet growing demand. The level of house building is at its highest for 17 years, but it is not enough. Moreover, without firm action there is no guarantee that growth will continue, as short-term market pressures mean some developers have slowed starts this year."We believe that a total of 3 million new homes are needed by 2020, and we will deliver 2 million of these by 2016. This will include new homes in the north as well as the south, as every region is seeing demand outstrip supply. In more areas we need additional affordable homes alongside areas of housing market renewal."Already locations for 1.6 million homes are identified in current regional plans, with up to a further 200,000 emerging in the new regional spatial strategies and future revisions to them. This includes 650,000 homes in the growth areas such as the Thames Gateway and Milton Keynes. "Forty-five towns and cities have already come forward with proposals for additional homes over the next 10 years in new growth points. We are today inviting more councils to come forward to be new growth points, including in the north of England. We are also inviting bids for councils and developers to come forward with proposals for at least five new eco towns. No one should be in any doubt about the historic scale of this vision; we are proposing the first new towns in 40 years. "Further changes are needed to support the delivery of these homes. Providing enough land is vital and councils need to identify 15 years' supply of appropriate land for housing, with the continuing priority for sustainable brownfield land. We will not change the rules on strong green-belt protection. We will introduce additional funding and incentives for councils and communities that are showing a lead in delivering growth—through a new housing and planning delivery grant, a new £300 million Community Infrastructure Fund, and additional funding dedicated for high-growth areas. "We are consulting on proposals to deter developers from seeking planning permission and then sitting on land without bringing forward new homes. We will work across Government to bring forward more brownfield land. I can announce that the MoD has agreed to bring forward six sites with the potential for 7,000 homes, including at Aldershot and Chichester. The Department for Transport has also identified hundreds of potential sites."We will support local councils in setting up new local housing companies with partners to use their own land to build more homes. I can announce that 14 councils have already come forward. They estimate that in their areas alone they have the potential to deliver 35,000 homes on their land, with 17,500 of them affordable homes. Better use also needs to be made of empty homes, including those left empty long-term by investors and speculators. Councils already have powers to take action and we will look at the potential for additional incentives for them to do so."Secondly, building more homes is crucial, but they must be better and more sustainable homes. In the 1960s, quality was sacrificed in the name of speed. We must not make those mistakes again. Today, our new homes must be part of well designed and mixed communities with excellent local facilities. This means more family homes as well as parks and green spaces, and with the urgent challenge of climate change they must be greener homes, built to the highest environmental standards. I can confirm that from 2016, all new homes will need to be zero-carbon. We are the first country to set such an ambitious timetable, and I welcome the support of councils, green groups and developers across the country that are committed to working with us to make this happen."As well as helping to prevent climate change, we need to ensure that our homes are resilient to its consequences. Over the centuries, many homes have been built in high-risk flood areas, and my right honourable friend has set out immediate action to support the families suffering dreadfully from the extreme weather. Since 1997, we have progressively strengthened the rules on planning to protect homes from flooding, with much higher standards brought in last year. These new rules require councils to consult the Environment Agency. Where the agency says that the risk is too high and councils persist against that advice, we in the Government will be prepared to take over those decisions ourselves. We will also look further at what needs to be done to be ready for future challenges. Later this year we will publish a new planning policy statement that will require local councils to plan more widely for the consequences of climate change."Thirdly, we believe that a decent home should be for the many, not the few. I can announce that we will invest £8 billion on increasing affordable housing over the next three years, an increase of £3 billion when compared with the previous spending review. This is on top of continuing investment in decent homes, including over £2 billion on the ALMO programme over the next three years. We have listened to the evidence from Shelter and the National Housing Federation. They have said that we need 70,000 affordable homes a year, of which 50,000 should be new social housing. I can announce that by 2010-11, we will deliver over 70,000 new affordable homes a year. By 2011 we will deliver 45,000 new social homes a year, with a goal of 50,000 in the next spending review. We will also deliver 25,000 new shared ownership homes through expanding existing programmes. Further, we will look to support tens of thousands of additional shared ownership homes through public sector land and local housing companies. As rural areas face particular pressures, we will set a specific target for increasing affordable homes in rural areas later this year after consultation with the regional assemblies."We want to see more work by local councils, housing associations and the private sector to increase affordable housing, both to buy and to rent. We are announcing today the first 10 ALMOs and local authority special venture vehicles approved to bid for social housing grant in order to build council homes. We are also consulting on changes to the rules on the treatment of rents and receipts from new homes which will give councils more flexibility to build on their land within responsible public finance rules."We believe that first-time buyers need more flexible and competitive products today. The Treasury is consulting on new ways to support more affordable long-term fixed-rate mortgages. We have also commissioned further work, led by Bryan Pomeroy, on expanding private sector shared equity products, and will launch new shared equity products next year. In the mean time, we will offer a new 17.5 per cent government equity loan for key workers and other priority first-time buyers."Taken together, these proposals represent not just the most significant programme of house building for decades, but an ambitious and positive response to the growing challenges that many people face in their day-to-day lives. To deliver it, we will need an expanded, skilled workforce. The new Department for Innovation, Universities and Skills will lead work to expand construction apprenticeships and work with partners in the sector to raise skills. We know that there is no quick fix for the issues we face. Building more houses takes time, so this must be a shared endeavour. Central government are today setting a bolder framework for the future, but we will achieve our goals only if those at regional and local levels in the public, private and third sectors and in local communities all play their part in supporting the homes we need."Building the sustainable homes needed by young people today and future generations is a test of our commitment to supporting people's aspirations and to achieving social justice. I commend these proposals to the House".
	My Lords, that concludes the Statement.

Lord Dixon-Smith: My Lords, I thank the Minister for repeating the Statement made by her right honourable friend in another place. I add my sympathy to all the home owners and owners of commercial premises who are caught up in the present disastrous flooding situation, and, indeed, to those who may yet be caught.
	I declare an interest in that I own land in Essex. It is always possible that some of that land may become eligible for development and it is right that the House should know that.
	The background to the Statement is perhaps not quite as rosy as the Minister stated because the Government have seen annual construction fall to a level below that in the 1920s. There has, of course, been some improvement since then, which is a great relief, but the annual housing construction rate is only a little over 50 per cent of what it was when I first entered local government. We cannot be easy about the present situation and, in the circumstances, I did not find it odd that the Prime Minister, in his programme statement last week, focused on housing and planning.
	Among other things, he referred to brownfield sites. I recall that that was included in an early policy statement by the Labour Government after the 1997 election. The former Deputy Prime Minister made much of what was going to be done—and I acknowledge that it has been very successful with brownfield sites—but there is nothing particularly new about that. There is going to be a review of government and publicly owned properties and the same comments apply; these were early adoptions of policy by the Labour Government. They have shown success but restating that does not take us forward.
	The Prime Minister referred to some 550 central government-owned sites with a capacity for 100,000 new homes and local government-owned sites for another 60,000 homes. The Statement refers, quite rightly, to the existing 1.8 million sites that are already planned and that the Government would like to have supplied 3 million new homes by 2020. If my arithmetic is somewhere near correct, that merely leaves us with 1,040,000 sites to find over the next decade and a half.
	I accept that this is the inevitable result of the planning system which, at the moment, is operating to rather too short a timescale, but the real question is: what steps are the Government taking to discuss and get the agreement of local authorities to these new figures, which I am prepared to accept are valid? There has been no resolution of the difference between local government and central government on this matter so far. In my view, the Government's handling of the issue has been somewhat inept but, without a degree of consensus, there is not much hope of achieving the Government's target.
	The Government's social housing programme is also welcome. Extra funding for 30,000 plus houses will be extremely useful and I acknowledge that it will do a great deal to expand construction in this field. However, social housing, by definition, needs to be where it is wanted; it needs to be in town centres and so on. Looking at sites such as old hospital park sites in green belts, brownfield sites such as redundant airfields, or the Government's suggested publicly owned sites, will not help on the social housing front. Social housing needs to have easy access to the work places of the people who occupy them. Again, the question is: what work is being done to arrive at agreement with local government on this issue?
	Finally, I turn to the difficult issue of building on flood-plains. I accept that it has a long historical background. Towns were inevitably built next to river crossings because that was where people gathered, and they have grown from that. There has always been a risk of flooding. Things can be done to ameliorate that but in the end, if the good Lord treats us in a hard way, there will be floods.
	What is being done to deal with additional flood protection? Much more could be done using artificial flood plains and better construction techniques. More could be done to protect the essential services in particular, such as electricity, gas, water and food, so that their sites were not affected by floods and those services would continue to be available. Part of the difficulty with the present situation is the breakdown of services because of the inability to protect those aspects of supply.
	That is quite enough from me. I hope the Minister will be able to answer these points, because it is an essential facet of resolving this problem that there has to be a high degree of agreement.

Baroness Maddock: My Lords, I, too, thank the Minister for repeating the important Statement on housing. I join with others in sympathising with all those who are suffering the terrible flooding in many parts of the country. I declare an interest as a member of Berwick Borough Council, which is a housing authority.
	The Statement seemed to gloss over the past 10 years. The housing situation has not suddenly come upon us, nor has it crept up on us; it has been obvious to quite a few of us during that time. It started when the present Prime Minister became Chancellor and, for the first two years, stuck to the Conservative spending plans on housing. Indeed, as time went on, the amount he spent became less than the money spent by the Conservatives in the last years of the John Major Government. I found that extraordinary, because the huge increases in house prices meant that the Chancellor was getting hefty sums of money in stamp duty that he had had no idea he would get. He missed a trick there, but I have said that many times before in this House.
	For most of those 10 years, it has been obvious to most people that household formation was outstripping housing supply at quite a rate. The Statement says that house building is at its highest for 17 years. That may be so, but we know that most of the houses are not affordable to anyone any more, and they are certainly not the right type of houses in the right places. We applaud efforts to build more affordable homes, but what steps will the Government take to keep them affordable? I commend to the Minister a system in south Shropshire, which Liberal Democrat councillors came up with and which I suspect civil servants know about, called "golden shares", to ensure that houses are kept affordable for local people in the future. I suggest that where homes are built on surplus public sector land—I think that about 550 sites are currently owned by the Government—community land trusts are set up. That means that when the houses are sold on for the first time, they remain affordable. I would like the Minister to reply to that, because it is important. Otherwise we will end up in exactly this position, with houses not being affordable.
	The Statement also highlighted the role of empty properties. Again, many of us have been working on that issue for years, and we had to drag the Government kicking and screaming to change the council tax regime on empty properties. Then what did they do? They gave the money to the county councils, which are not housing authorities. In our authority we do not get it all back to spend on local housing. Another issue that I have raised many times is VAT on repairs. Many empty properties need repairs and refurbishment, and whereas there is no VAT on new build, there is 17.5 per cent tax on repairs.
	I welcome the Government's recognition at last that local authorities best understand the housing needs in their area. But I am a bit confused about the accountability for the spatial strategy. When, some years ago, we dealt in this House with the Planning and Compulsory Purchase Bill that gave the regional assemblies the power to deal with the spatial strategies, I did not expect the regional assemblies to disappear, which I now understand will happen by 2010. However, the Government will now consult them on the new spatial strategies.
	I hope that the Government are clearer in their mind than I am, given all the things that have happened. One of the references to rural areas is to consult the regional assemblies. In my part of the country, north Northumberland, we are allowed to build about 80 houses a year. We need more than that to keep our communities sustainable, yet the power to influence the spatial strategy has been virtually nil. I hope that the Government will take note of this. In some areas, 50 per cent of houses are second homes. I do not know what the Government are planning to do about that—there was nothing about it in the Statement. Everybody recognises that where 50 per cent of homes are second homes, a lot of facilities, such as post offices and schools, disappear.
	Over the past 10 years, social housing has been a Cinderella area, not in terms of refurbishment but of new build. I welcome the fact that the Government are trying to do something about it. Again, this situation has not crept up on us—we have lost lots of social housing because of the right to buy and the inability of local authorities to replace those houses. The Government again came late to that.
	On green homes, Scandinavia and northern Europe have for years been building far more environmentally friendly houses than we have. I welcome the Government's conversion but, by golly, it has taken a long time. But there is no mention in the Statement of the existing homes, many of which are very energy-inefficient. I know that the Government have put money towards that. In another place, my Private Member's Bill tried to do more about it—but that was 12 years ago and we still need to do something. Again, the VAT is important in this regard.
	Will the Minister really look at some of the things that the Government are setting up? I have just returned to local government after about 14 years, and what strikes me is the bureaucratic systems that the Government are setting up. I notice at least four more in this Statement—the community infrastructure fund, the housing and planning delivery grant, new local housing companies and authority special venture vehicles. The Government are consulting on the rules on the treatment of rents and receipts from new homes. I can remember the days when local authorities had a lot more freedom; they knew what the people in their areas wanted and they built some very good homes. I hope that the Government will listen to local authorities—please, please do not make the situation more bureaucratic than it already is.

Baroness Andrews: My Lords, I think that I detected in those responses a welcome for some of the things that the Government are doing, although in some cases it appears to be a question of too little, too late. Nevertheless, I think that there is a consensus across the House of how important it is to meet the needs of young people who are falling off the property ladder or not even being able to get on it, and to address the very serious problem of housing.
	The noble Lord, Lord Dixon-Smith, and the noble Baroness, Lady Maddock, criticised the fact that we may have glossed over the history of this problem. It is not recent; over the past 30 years, there has been a 30 per cent increase in household formation and a 50 per cent drop in housebuilding. The problem is not 10 years old; it goes back much further. But in the past 10 years patterns of family change and formation have been accelerated and different. The major pressure is coming from single people choosing to live alone, and many of those are now part of our ageing population, so we have new pressures and patterns in the system to which we must respond.
	There has been a significant increase in housebuilding in the past year, with a net addition of 185,000 homes. It is therefore important that we look seriously at the history, but also acknowledge the significance and scope of what we are trying to do. I was grateful to the noble Lord, Lord Dixon-Smith, for listing some of our efforts on brownfield sites and in bringing forward public land. Not only do we have a good record on brownfield development, but surplus land now goes much further. We are looking for new approaches to toughen up the register of surplus land, which will have to be much more reflective of housing policy. In planning policy statement 3, we made clear to local authorities the need to bring forward land for five and 15 years' supply, so that they can predict and plan much more robustly. I know that the noble Baroness, Lady Maddock, described the National Housing and Planning Advice Unit and some other organisations as bureaucratic, but they are about delivery. The Community Infrastructure Fund has delivered just over £1 billion to the new growth areas in this country for infrastructure. We have these vehicles for a purpose. I can assure noble Lords that we are not in the business of inventing new bureaucracies.
	The noble Lord, Lord Dixon-Smith, asked what steps we are taking to ensure a reconciliation of ambitions between local authorities and national government. That is an important question. The final part of my Statement was about the need for a partnership between everybody who is concerned about housing supply. It is entirely proper that the Government should set ambitious targets for housing, because it is their responsibility to enable people to live in a decent home. That is where the buck stops. The process of deciding with local authorities and regional organisations where, and what sort of, houses should be built is tested in public and by examination, and negotiated through the regional spatial strategies. It is a robust process over which local authorities have great influence.
	We said in the announcement on the sub-national review last week that planning would move to the regional development agencies—the noble Baroness, Lady Maddock, made a point on this—because we need a regional economic strategy that brings everything together, including housing, planning and skills. That has implications for the regional assemblies, but it has implications also for local authorities being able to play a much more robust role in the beginning. That is what the Local Government Association wanted.
	On social housing, I say to the noble Lord, Lord Dixon-Smith, that, wherever we build, we have to have a proportion of affordable housing. No developer is going to get away with not building affordable housing. Social housing is as much needed in rural areas as it is in inner cities.
	We take the risk of flooding very seriously, as the previous Statement made clear. We must prevent it. Our new flooding statement, PPS 25 of last December, pointed to the need to ensure that flood risk from all sources—not just from rivers but also, particularly in today's instances, from surface water—is taken into account at all stages of the planning process. Inappropriate development must be avoided; development must be directed away from high-risk areas. We have announced a review of the lessons learnt from the 2007 floods and will see whether there are implications from its findings. Yes, we need to make space for water as well as to deal with floods, just as the noble Lord described. Our building in the Thames Gateway and other growth areas is tested against that.
	I was pleased that the noble Baroness, Lady Maddock, drew innovative schemes to our attention. Throughout what we have said about local authorities' capacity to build more in different ways with different partners, we are looking for and at innovation.
	I was asked about equity sharing. We aim to help 120,000 people through equity-sharing arrangements by 2010. In addition, we have come forward with a new product, which involves a government equity loan of 17.5 per cent, which will make matters even easier.
	I have spoken about the accountability of the spatial strategy. I was asked about green homes. Our ambition for new homes is simply for them to be carbon free by 2016. The homes in which we live now can be hugely improved, which is why we have brought forward energy performance certificates and why we are advocating better ways of conserving water in different systems. In addition, schemes such as Warm Front will help people not only to reduce their bills but also to be safer and warmer through the winter.
	I hope that I have addressed most of the questions raised by noble Lords. I shall certainly make sure that I do so in writing if I have not.

Lord Campbell-Savours: My Lords, does not this initiative give us the opportunity of dealing with the scandal of the abuse of affordable housing targets, particularly in London? Now that the GLA Bill is nearly through, will my noble friend reconsider my proposal in Committee on the GLA Bill, which was based on detailed research of this abuse in London, for footage percentage, and not unit percentage, calculations to be used in affordable housing decisions in London, because we are simply not getting the number of units that we need?

Baroness Andrews: My Lords, my noble friend made a powerful contribution in Committee. I am still not completely convinced that it is the solution, but I can assure him that we have read his contribution seriously, particularly the cases that he brought to our attention. I will get back to him on that.

Lord Marlesford: My Lords, I declare an interest as a former member of the Rural Development Commission, along with the noble Lord, Lord Best, and as the owner of a farm and houses in Suffolk. Has the Minister had the opportunity of reading an important article by Sir Simon Jenkins in the Sunday Times of 15 July and, if so, does she agree with any of the substantive points that he made? Given that the Government have an obligation to try to ensure that the people of this country are decently housed, does she recognise that this really should mean increasing the supply of rented housing, where the occupant rather than the house is subsidised? Does she recognise that there can be no obligation, if only because it is unachievable, to ensure that everyone who wants to own their home can do so regardless of their means, because to offer to do so will lead only to disappointment? Lastly, has the MoD included RAF Northolt in its six sites on offer for brownfield development?

Baroness Andrews: My Lords, owing to the courtesy of the noble Lord, I am familiar with a little of the article by Simon Jenkins, who has been a consistent critic of government housebuilding policies. On reading it quickly, I do not think that there is much in it with which I agree, but, if the noble Lord will allow, I will come back to him with a proper response. The article states:
	"The reality is that Britons squander their limited living space more than any country in Europe".
	I do not agree with that, having seen how other countries in Europe build with enormous profligacy across enormous spaces. I am sure that I will find other things to disagree with as I read on. If we do not do anything more than we are doing at the moment in this country, by 2016—it may be 2026, but I will have to check—the ratio of house prices to earnings will be 10 to one. We cannot afford not to do anything about it. The noble Lord's point about the importance of rented housing was absolutely correct. We need all sorts of different forms of housing. We must look seriously at that sector as well. I cannot give an answer to his question about RAF Northolt. I shall write to him and give him an idea of the identified sites of which we are aware.

Baroness Hamwee: My Lords, the Statement mentions building council homes. Why is it therefore necessary to create local authority special venture vehicles to do so, rather than allow local authorities to build local authority homes? Secondly, will the Minister say something about the infrastructure that will be required to enable the development of large sites such as those belonging to the Ministry of Defence? I do not mean just transport; I mean everything that is required to make a community function, including schools, health centres and so on. Thirdly—and this is also an infrastructure point—noble Lords have mentioned flooding and building on flood plains. Does the Minister accept that the intensification in town centres will have an impact on drainage and sewerage and that everywhere with a Victorian sewerage system must therefore be high risk?

Baroness Andrews: My Lords, on why we need special ventures and do not simply tell local authorities to go ahead and build, we have taken the decision over some time now that the better role for local authorities is a strategic one, in determining needs and provision rather than building. Other people build and develop better, not least the housing associations, which can borrow money on the open market. That is why, for example, we have been able to raise £19 billion for the decent homes strategy, which uses the local authorities.
	The special venture vehicles, along with the new local housing partnerships, are new ways in which to raise capacity and increase the role of local authorities in innovative ways. Some local authorities have been very open with us about the lack of capacity. This is what will make sense with regard to deliverability.
	As for infrastructure, the noble Baroness is absolutely right. The sort of infrastructure necessary to be planned into the new growth areas is why, for example, more than £1 billion in growth area funds and £200 million from the Community Infrastructure Fund have been awarded so far. Those sorts of infrastructure are accompanied by massive investment in education, schools, new health centres, transport and so on. This is very much a coherent programme and we are very well aware of the implications. The Treasury cross-cutting review on infrastructure is looking at how to pull all this together.
	Building communities is about more than building physical infrastructure. It is about community building: building memory in and building activity for young people, with safe green spaces, and creating spacious places to live, which you can do even in dense communities. That is what people want. Throughout this Green Paper and planning policy statement 3, we make it absolutely clear that we are not in the business of building homes or estates. We are building communities, which need lungs and space to thrive. That is important, as is the question of quality, which runs through this Green Paper.
	The noble Baroness asked about flood plains and town centres. There is an issue here about intensification of use, but it is not confined to town centres. One reason why the water companies are addressing the issue of repair to such an extent is the real need in that regard. Drainage and sewerage systems are as important as, if not more important than, providing fresh water supplies.
	On the figure that I gave about the income ratios, the ratio between prices and earnings will be 10 to one by 2026.

Baroness Ford: My Lords, I thank my noble friend for repeating the Statement made by my honourable friend the Minister for Housing in another place. We should be generous in extending our welcome to an additional £3 billion investment in the next spending period on social housing, and £8 billion in the period to 2016.
	I draw attention to two aspects of the Statement that are extremely welcome. We are unusual but not unique in this country in not having a single mechanism for wholesaling public sector assets and land. Many other countries do that before they decide whether public assets are surplus. The Statement moves us a long way forward in giving the Register of Surplus Public Sector Land some teeth. It is excellent news that we are putting an end to the practice of selling public sector land and assets with no regard to housing policy. That is extremely welcome.
	I also welcome the return of local councils sponsoring developments in their local areas. Will my noble friend reassure us that we are talking about not a return to wholesale mono-tenure council housing of the type that we saw in the 1950s and 1960s but rather a return to local authorities sponsoring mixed developments in their areas, with a whole range of tenures and houses for sale in communities?
	We should remember that over the past 40 to 50 years, as the noble Lord, Lord Dixon-Smith, rightly pointed out, there was a decrease in construction. But over that long-running trend the private housebuilders have held up the numbers; the withdrawal from publicly sponsored housing almost entirely accounts for that decrease in housing numbers. So it is very welcome that after 20 years the Government have decided to do this. I thank my noble friend again for the Statement.

Baroness Andrews: My Lords, I am very grateful to my noble friend for raising those issues. I take the opportunity to thank her on behalf not only of the Government but of everyone who wants a decent home for the sort of work that English Partnerships has done for the near and long-term future in bringing land forward and being so proactive and supportive of these ambitions. She is right in saying that we have not had a very toothy register so far, but we will have one now and it will make a big difference.
	I can certainly give her the reassurance that we are not in the business of building housing estates. One thing that the Green Paper makes clear is that we very much want local authorities to build mixed developments. We do not want ghettos or just flats being built; we want family homes, large family homes and mixed developments, so that people of all incomes and tenures can coexist harmoniously together. That is very much a clear steer for future building. Some of the new settlements—in the eco-towns, for example—will be extremely broad in terms of their tenure arrangements.

Lord Patel: My Lords, can the Minister confirm that the information that I have is correct and that overseas or non-British citizens who invest in property in this country do not have to pay stamp duty or capital gains when they sell their property? Can she confirm, too, that British citizens resident overseas who sell their property before returning do not have to pay capital gains tax? If that is correct, it obviously has implications for housing.

Baroness Andrews: My Lords, I believe that the noble Lord is right, but I am not absolutely certain and I shall have to write to him when I have made absolutely sure. I shall certainly write if I am wrong.

Lord Bruce-Lockhart: My Lords, does the Minister agree that often it is simply the lack of infrastructure funding, particularly for transport, not the issue of targets, that has held back the delivery? Today we are completing some 40 per cent fewer houses a year than we were in the 1970s. To give an example of why targets are not the problem, in my own local authority area in Kent we have a nine-year land bank available now of housing land allocated in local plans, but it is not being built on simply because of the lack of transport infrastructure. Eighteen months ago, the IPPR report said that transport infrastructure today was less than it was in the early 1990s. Furthermore, does the Minister agree that the much more devolved system enjoyed by European countries in relation to transport infrastructure, economic development and housing powers has been shown to deliver more houses and to keep supply in much better balance with demand?

Baroness Andrews: My Lords, I am sure that the noble Lord has a case there. Building in transport infrastructure, when one is trying to get release of land, is nearly always very complicated. You can see that across the growth areas. However, the highways agencies are working very successfully and more effectively now than they have been. The noble Lord will know that we have looked at different ways in which to strengthen these sorts of arrangements through the sub-national review.
	I must correct something that I said earlier. The figure of £1 billion that I gave for communities infrastructure is the amount for our own funding from CLG from 2003 to 2008. I may have given the impression that that was an annual figure.

Lord Graham of Edmonton: My Lords, I congratulate the Government, the Minister and her ministerial colleagues on the range of policies that are contained in the Green Paper. She ought not to be put off by the critics who say, with hindsight, what has not been achieved. In my view, the Government are wise to acknowledge that much more could be done, but, at the same time, the House should recognise that a great deal has been done and that what has been said promises even more, especially on affordable housing. Will the Minister look at that situation?
	When the right-to-buy policy came in in 1979, it was very popular, not least because those who already had the largesse of a tenancy from a local authority had the additional bonus, if they sold the property� of receiving large cash sums. In Edmonton, where I was Member of Parliament, we found over the years that properties that were bought for 7,000 or 8,000 were changing hands for over 100,000 in a very short space of time. The greatest boon that the Government can give, through agencies and directly, is tenancies to those who are desperate for a house. That ought not to include a hidden bonus that, at some time in the future, they will be able to sell it and get hundreds of thousands of pounds. Is the Minister aware of that aggravation and can she say something about readjustments to the present policy? It was a bribe then and it is a bribe now.

Baroness Andrews: My Lords, I shall have to disappoint my noble friend. For very good reasons, we remain committed to home ownership as an aspiration. We have supported the principle of the right to buy, although, over the years, we have changed the conditions. We do not have any plans for changing the terms of the right-to-buy policy, but I know that he will be very pleased by our commitment to new affordable housing: at least 70,000 by 2010; 45,000 new homes each year, or 50 per cent more than this year; and 8 billion over three years. It is a very significant investment, which will help the kind of people about whom he has always been concerned throughout his long political career.

Lord Low of Dalston: My Lords, I welcome the Statement and the Minister's subsequent remarks about the importance of quality in building and of building for communities, not just housing for its own sake. Does she agree that in the dash for housing it is important not to neglect quality and to remember the importance of the human scale of development? From what she has said, I am sure that she does agree with that, but I invite her to recognise that, if we are to live up to the aspirations of which she has spoken in the Green Paper, a change of policy will be required in certain areas. I am certainly aware of proposed developments in the area of London in which I live where those principles will not be adhered to unless we see a change of heart among those who sponsor them.
	I know from travelling around the world, as I do, that it is possible to build high-rise buildings on a substantial scale and yet imaginatively, in a way that is congenial for communities to live in. I have just been to New York where there are in busy streets wonderful refuges of small open spaces with water features and so forth, which make living in those areas a delight, compared with some of the developments of which I have spoken and which are proposed. I invite the Minister to recognise that if we proceed with faceless tower-block buildings, we are likely to have the sort of problems that have been experienced in the Paris banlieues on our hands in a generation to come.

Baroness Andrews: My Lords, I could not agree more with the noble Lord. As we said in the Green Paper, we have to ensure that we are as conscious of quality as we are of quantity. We shall certainly expand our partnership with CABE, which we have had over many years, and which has been invaluable in terms of articulating what we think of as good design and quality. I am sure that that will be very successful. The noble Lord is absolutely right about small open spaces. In recent years, one achievement has been the renaissance of our parks. In building new communities, whether in airfield sites or eco-towns, we will have a wonderful opportunity to pioneer new ways of living and new types of community living. I hope that in due course Scandinavians may come here, rather than us going to Scandinavia, to see what can be achieved on sustainability and beauty.

Local Government and Public Involvement in Health Bill

House again in Committee on Clause 222.

Earl Howe: moved Amendment No. 238KC:
	Clause 222, page 154, line 30, after on insert effectively

Earl Howe: I shall speak also to Amendments Nos. 238KDA, 238KF, 238KH, 238L and 238LE. One thing that makes people like me suspicious about what is to emerge from the Bill is the phraseology of Clause 222(2). To put it at its simplest, the activities that are described in the subsection are all about process; they are not about outcomes. That pertinent point was raised earlier by the noble Baroness, Lady Neuberger. It is as if all that matters is that someone observes the carrying on of health and social care commissioning and provision and obtains people's views. What is the point of that activity? The point is to improve the quality of local services. Why do we not say that that is what LINks are there to do? Equally, why do we not say, in terms, that it is not enough for the contract with the host to specify that the activities mentioned are carried on; the contract needs to have as its aim that those activities should be undertaken effectively.
	There is a very sterile and neutral feel about the wording in this part of the clause. Surprisingly, there is not even any mention of one of the main aims of patient and public involvement, which is to try to promote the interests of those people in the community whose voice is less often heard, or who, for one reason or another, are the victims of health inequalities. A good LINk will tackle social exclusion head-on and try to remedy it.
	Perhaps I can illustrate that idea briefly. The Minister will be well aware that life expectancy varies depending on the area of the country where one lives, Manchester being the worst area for both men and women. If those with the shortest life expectancy do not have equal influence on services, the potential of those services to deal with these issues will be lost. A good example might be stop-smoking services, which need to be offered at the times of day and in the locations when those of working age in manual groups, which have higher rates of smoking, may access them easily. If they are involved in the design of services, those kinds of issues could be raised. Similarly, smoking in pregnancy is more than four times higher in social class 5 than in social class 1. The involvement of women from deprived areas in designing antenatal services could improve the success of those services. We know that the rate of perinatal mortality is twice as high among mothers living in the most deprived areas. It is essential for these groups to be involved in services so that they are designed effectively. There are any number of other examples, not leastit is fresh in my mindthe need to involve black and ethnic-minority patients in the design of psychiatric services.
	I hope the Minister will accept that that is a real issue. If LINks are able to make reports and recommendations to those with the appropriate power to change things in the health service or social care, then there should not be an artificial restriction on to whom they can report. The wording does not make it entirely clear and I would be grateful if the Minister could confirm that the persons responsible for commissioning, providing, managing or scrutinising local care services could include, for example, the Healthcare Commission and CSCI.
	What are we to understand by the definition of care services in Clause 222(5)? We see here that,
	'care services' means
	(a) services provided as part of the health service in England.
	That might seem perfectly all right until we remember that not everything that a patients' forum is currently able to report on relates to health services as commonly understood. For example, concerns may be expressed about car-parking charges, waiting areas for hospital visitors or transport arrangements. These are matters that contribute to the patient experience in the broad sense but they are not directly to do with care. Can the Minister confirm that such matters will not be excluded from the purview of LINks? I beg to move.

Baroness Neuberger: I support the noble Earl, Lord Howe, in everything he has said. I will also add a few words to what he said about Amendments Nos. 238KD and 238KE.
	The clause states that it is to enable people to monitor the local health activities. Instead, we have inserted,
	members of the local involvement network.
	If we are moving to LINks, and it seems fairly clear thatwith all the queries that we havewe are, then it is right that we should say so and say what we mean about membership of those LINks. I am enormously grateful to the involvement network, which is a network of hosts, for the information it has submitted. It suggested that we must move to a system where LINks are sufficiently flexible,
	to allow members to respond at least as quickly and effectively, in the interests of those seeking or receiving service, as the Forums can do now.
	About forums, it said that they,
	generally have developed small, trained and experienced teams made up of members,
	and other participants,
	who are able to respond and take action faster and with a different perspective than other scrutiny or regulatory bodies.
	It added that,
	they are often more effective at eliciting a response because they are more down-to-earth, can work more simply and directly, including with staff at all levels,
	and they,
	remain focused on what matters to patients and their families.
	That is exactly what we want LINks to be. The involvement network has suggested that we need to create classes of membership for LINks, and that might mean having a variety of memberships for groups and for individuals and at many different levels. Whatever it is, we need people to be members of that entity. The incredibly loose network that the Minister described before the Statement seems to be too loose to be bearable.
	However the model works, there must be some sense in which LINks have members. Anna Coote, a former colleague at the King's Fund who was on the group that looked at the new structure and who is now at the Healthcare Commission, suggested in her evidence to the Health Select Committee that the original idea was a true networksomething very loose indeedbut that it was shifting somewhat. The Health Select Committee argued that the Department of Health was reluctant to talk about membership of a LINk, but we argue that if LINks are to do anything and gather views properly they will need members and some clarity of what kind of entity they are. It is essential, however loose they are or how many classes of membership there may be, that they know who their members are and who they can charge with taking on various functions, duties, activities or whatever it is they will be called.

Lord Rea: In lending my support to these amendments, I will speak briefly to Amendment No. 238KL.
	Before that, I should explain to my noble friend why I have added my name to a number of the amendments being debated today. My noble friend will remember that I was critical of the Government's decision to abolish community health councils in 2002, feeling that they should be strengthened and reformed instead. Their successor, the patients' forumsI prefer to say foraare now to be abolished in turn instead of being strengthened, perhaps with their structure and functions revised in light of experience and developments in the National Health Service and other social institutions.
	Just over a week ago, my noble friend Lord Layard wrote an article in the Guardian entitled, No change for change's sake. I will quote a small part:
	Reorganisation is much less important than some think. In fact, many different organisational structures can be made to work equally well. What cannot work is constant reorganisation, where nobody understands what is happening, institutional memory is lost, and everybody worries about their future rather than the job in hand.
	Exactly. However, the Government have gone so far down the road to establish LINks, instead of patient participation for a, that our job today is to probe the Government's arrangements for setting them up and ensuring that they work smoothly rather than seeking to attack the whole concept. In fact, the concept of LINks is admirable in many ways, particularly in that it covers the area of local authorities, rather than individual trusts. It also includes primary care andbetter than anythingsocial services in its remit. It is potentially an extremely valuable reorganisation, although its remit could have been included in those of existing bodies. The Government have said that, by leaving some of the wording of the Bill non-specific, they will allow for flexibility in operation, but we feel that inserting certain words will make it easier for those setting up and working in LINks to carry out their tasks and to know what those tasks are.
	The main purpose of the amendments, as noble Lords have said, is exploratory. It is appropriate for me, as a government Back-Bencher, to join the cross-party group that has tabled these amendments given that many Labour Party members and supportersnot least on the Health Select Committee of another placeare very concerned and have misgivings about the Bill.
	I want to talk a bit about Amendment No. 238KL. Its purpose is to expand how LINks are to obtain the views of the population in their areas. Clause 222, at page 154, line 36, talks about local authorities,
	obtaining the views of people.
	That is extremely non-specific. That means that they can just go into the street and ask the views of a selection of passers-by. The amendment inserts, instead of obtaining,
	supporting members of local involvement networks to obtain,
	this information, thus delineating more clearly how the LINk is to work. This is one of a series of amendments to clarify the structure and function of LINks.

Baroness Meacher: I support the concerns expressed by noble colleagues regarding these amendments. They have been well put and I very much hope that the Minister will take them seriously.

Baroness Masham of Ilton: I am in exactly the same position as the noble Lord, Lord Rea, on these amendments. Will the Minister give us examples of who may be the hosts for LINks and what happens if they suddenly move or go brokeespecially if they are housed in a voluntary organisation?

Baroness Howarth of Breckland: I want to speak to these amendments to probe further a question which I remain unclear about, although I had hoped it to be clarified in the previous group of amendments. I was somewhat disappointed when the Minister gave us the impression that some of us, by probing these issues, might not be in favour of change. I think that change is often extremely positive but, to take change forward, we have to understand how we harness the energy of those involved in existing services and do not demoralise them. The management of change is around gathering people with you and taking you forward with their energy. If we are to take these changes forward, we have to conceptualise what this is aboutand I am struggling to do that, particularly when I read in Clause 222 that the activities include,
	enabling people to monitor, and review, the commissioning and provision of local care services.
	The commissioning of local care services is a highly complex process. What kind of organisation will we have? I continue to use that phrase, What kind of organisation?, because I do not know the terminology with which to describe the matrix it appears that the LINks will be. I agree with these amendmentswe have to have some sort of form and structure, some sort of membership and some sort of understanding of the host. I agree with my noble friend who asked who the hosts will be. I do not understand that and have very little idea of what their governance relationship is with the local authority or the primary healthcare trustor, indeed, how those two relate to the LINks in terms of governance.
	I am sorry if this is losing some thread in our discussion and the nature of the documents that have been sent out. I have tried to follow it, but, as the noble Baroness will know, I spend a lot of my time in governance and trying to sort out some of the difficulties of change that the Government have created, which have not been too easy. I ask these probing questions simply because I am keen that we do not again create an animal that is unmanageable and something that we will have to unpick. This is a crucial change for the future.

Baroness Howe of Idlicote: As host has been mentioned, can the Minister say whether it is appropriate now or at a later stage to consider why we need hosts, how they will work, how much money they will have and whether they will be voluntary organisations that do not get involved in the work that was going on? Those will be very important points to explore later and I very much agree with what the noble Lord, Lord Rea, said, because he put some of our concerns very effectively.

Lord Bruce-Lockhart: I add my support to this group of amendments, particularly Amendment No. 238KG, on,
	supporting members of local involvement networks to obtain,
	their experiences. I wish to add to my noble friend Lord Howe's search for clarity on the purpose of LINks.
	Perhaps I may use an example from my local authority in Kent. Three years ago it wanted to support the patient forums by establishing an independent focal point to allow patients and residents to report their experiences of the NHS. We have, like many local authorities, a 200-seat, 24-hour-a-day call centre. We were simply suggesting that people could phone in, because one of the problems of patient forums isand one of the problems of LINks will bethe large amount of anecdotal evidence. What they need is a professional organisation to take widespread opinion, to analyse that and produce hard evidence of patient experiences. This seemed a good idea. We called it Kent Health Watch, but at the time it was opposed by the NHS health authority. However, such an idea would be immensely valuable. Amendment No. 238KG and the clause bring that out. Will the Minister support the establishment of that kind of patient information base, which is very important both for information and choice?

Baroness Andrews: This has been a thorough debate on some complex issues. I much admire the noble Earl's struggle with language. Sometimes we seem to exist in a virtual universe when we consider the language of parliamentary draftsmen. That is not unique to this Bill, but it is, perhaps, perplexing here. The noble Earl also did the House a service by emphasising how important it was for the LINks networks to be as wide as possible. The examples he gave, not least regarding the relationships of black and ethnic minorities with mental health services, were absolutely right. All I would say is that that is precisely why we have not listed organisations in the Bill or defined the scope and extent of a LINk, simply because we have made it clear in everything that we have written and sent out that the test of a LINk will be how far it reaches into the community.
	I say to the noble Baroness, Lady Howarth, that I certainly did not mean to denigrate people who manage change and who have had successfully to manage a great deal of change in recent years. I understand why she pushed me on clarity and I will do my best to conceptualise this and to answer some of the question that arise.
	Amendment No. 238KC seeks to insert effectively in relation to the means by which LINks arrangements can be delivered. What we mean by effective is, essentially, that LINks will be organisations with sufficient scope, as I have said, to bring in the widest and most effective range of influences for different purposes. Those influences may be very specific to an interest group made up, for example, of people clustered around the independent living agenda. The influences may be broad in relation to changes proposed whereby this alliance, this network, will have a collective view of the impact it will have or some of the changes that it wants to see. Some of those changes may run across interests and conditions but will affect a particular age group, such as the elderly or the young. So there will be, I am afraid, infinite variety. It is that sort of inference.
	The test of effectiveness is that there will be governance arrangements which are clear about the relative role of the host. The LINk will take decisions on priorities and activities and the host will provide the necessary support for them to carry it out. In all the documentation we have put out, that distinction and the need to be clear about that is vital. There will be clear and responsible partnerships with stakeholders, such as overview and scrutiny committees. Local partnerships will establish the role in relation to commissioning, at what point the LINk organisation and in what forma group, a small sub-committeewould have a role in looking at the commissioning of particular services, maybe specialist services. Those sorts of things can be determined as the structure evolves.
	There are clear accountabilities in the system. Local authorities have a duty to make arrangements to establish a LINk. The host will be accountable for the delivery of the contract and provide appropriate support, advice and infrastructure. The LINk is accountable to the community. It will reflect the range of organisations and interest groups which have an interest in the whole range of services and working with them to obtain the voices, it will determine priorities for work programmes in accordance with the issues which matter to local people.
	We sought at the outset to establish a means of informing ourselves and local authorities on what will work best, and that was the point of the earlier adopter schemes. They are not pilots; they are earlier adopter schemes, attempting to show how different models of activity may work, how people can be engaged in different ways, how LINks can be governed, and, in short how they can be as effective as possible. We have just completed nine regional events at which we asked all stakeholders interested in LINks for their views on how the arrangements should be set up. The responses indicate that people were really keen for options to be set out in guidance on how best to deliver LINks' functions and structures, how best to engage, how to reach the seldom-heard groups, how to make model policies on areas such as codes of conduct. No one has asked for that to be put in legislation. They have asked for help and guidance on how to formulate it. It seems to me that that is the responsibility of Government.
	We have consulted many voluntary and community organisations and there is a huge range of experience among them for obtaining responses and voices. The model contract specification was drawn up with their input to make sure that it set out the key features, which may well have been things that LINks are not as well as things that LINks should be.
	On contracting, local authorities are very accustomed to contracting local service providers and performance-managing those contracts. We explored the great variety of innovative arrangements at an early stage of this Bill. Local authorities are increasingly confident about new types of arrangements. By giving them a clear duty to make the arrangements necessary to establish the support LINks, we have chosen the right organisation to fulfil the role.
	I return to the notion of effectiveness. No, I will not return to the notion of effectiveness; I shall go on with the logic of what I was saying.
	I turn to Amendments Nos. 238KG, KE and KG. They seek to articulate the notion of members of LINks. My noble friend asked how one obtains the views of people and I would say to him that there is a huge range of options. I take the point he is making. I am not sure that I agree with him but I listened hard to what he said. The point is that there is an enormous range of experience on how to obtain voices, not just through existing organisations, which are often membership-based and therefore have responsibility to reflect their members' views, but also through the new range of technologies which make it very easy indeednot least e-gov with its direct relationship with local governmentfor people to text or e-mail what they feel about things. So we have ways of doing this which we did not have before. The example given by the noble Lord, Lord Bruce-Lockhart, in relation to this was very interesting and I would like to think about what he said.
	This batch of amendments is generally about giving identity to LINKs; giving members individual or collective identity or responsibility. I come back to where I started on the previous amendment, to the need to allow for flexibility and self-design; the need people themselves to say that this is the sort of organisation they want and that it is what will work for them. Obviously there will be participants in LINks who want to take on a more active role than others, who want to form the steering committee, and they will be enabled to come forward. The host's first task is to identify who in the local area is active, involved and committed and who among those committed organisations, as they come forward, might be willing to take on some of these responsibilities. It will be an open but negotiated process. We have not prescribed whether there should be a board or a steering committee but it is very unlikely that there would not be.
	In terms of membership, the noble Baroness, Lady Neuberger, asked why certain people could not be members. The involvement network has come up with some interesting ideas but it would be difficult to put classes of membership in the Bill. A company limited by guarantee or a charity could be members. There is nothing to stop it being a membership organisation but this should be for local people to decide. I know it is not easy. We are wrestling with a bit of a miasma but that is in the nature of what we are trying to achieve.
	The noble Baroness, Lady Masham, asked who the hosts are and what they do. Hosts are organisations made up of the same sort of people who supported the patients' forums. They can be voluntary organisations or social enterprises. The acid test is: do they know the field? Will they be able to be inclusive, to know who is able to or wants to make a contribution? Are they organisations that understand health and care matters? They could be an organisation in the field or a care provider, or a voluntary organisation dealing with health. They could also be a citizens' advice bureau. We will have to see what comes forward and what capacity they offer the local authority. This is the test the local authority will impose. Can they do what we want? Are they sufficiently familiar, confident, trustworthy, open and capable to host and provide the infrastructure for this new organisation? We have not said what organisations should come forward for that reason. What happens if they go bust? There will be a rigorous process in awarding a contract but if they go bust, it will have to be retendered.
	Let me say something about commissioning. PCTs and local authorities have a duty to seek the views of local people, especially in commissioning decisions. LINks will be an ideal resource for commissioners to enable easy access to people who are interested and knowledgeable about that process. I think we have a natural synergy there.
	I have dealt with the hosts; let me come back to the notion of people. We do not think it is right that people should be identified in the legislation as having specific power or responsibilities. The intention of the legislation is to define the LINk's functions rather than how it should be managed or governed. As I have said, there will be different ways of doing that.
	Amendment No. 238KF seeks to require that the activity of a LINk to monitor and review the commissioning and provision of services is for the purpose of securing and maintaining improvements to those services. I think the purpose is a good one. I can see the argument but I want to take this away and think about it, because getting something in the Bill about securing and maintaining improvements could be helpful. I have to consider how it could be applied to all of LINks' powers rather than just one so there will be some implications to be teased out.
	Amendment No. 238L seeks to ensure that the list of LINks' activities given in Clause 222(2) includes that the LINks can make their reports and recommendations to the bodies responsible for services. As it is currently drafted, subsection (2)(d) states that LINks can make,
	reports and recommendations ... to persons responsible for ... services.
	It is not necessary to amend that to read persons or bodies because, in the legal context, persons includes a body of persons and therefore applies to institutions that are responsible for services.
	The noble Earl asked whether LINks would be able to make reportsrequire responses, as it wereto the Healthcare Commission or CSCI. No; LINks will be able to make reports to regulators but they are not included in this list because they will not be under a duty to respond, as commissioners will be. There is a distinction. LINks reports are to be sent to local organisations that commission care services, not to national bodies, to emphasise the local LINk rather than the national commissioning body.
	I turn to Amendments Nos. 238KD and 238KH. I absolutely agree that it would be important for LINks to promote involvement opportunities to encompass the views of the entire population, as I said, including those who are hard to reach. The activities for a LINk listed under Clause 222(2) already include promoting people's involvement and obtaining views. The most reassuring thing that I can say to noble Lords is that we will be setting out in guidance the importance of doing that and collecting best practice about how it is already done.
	I will have to write to noble Lords about Amendment No. 238LE; I do not have the answers to hand.
	Finally, the noble Earl, Lord Howe, asked whether LINks will be able to consider transport or access to services. Yes, LINks will be able to hear many views on matters relating to healthcare; it will not be confined to the delivery of health services per se. It will cover all the things that make a difference to the way in which people access and perceive their health services.
	I am sorry; I seem to have spoken for quite a long time. I hope that I have given some of the answers that noble Lords were looking for.

Baroness Masham of Ilton: Before the Minister finishes, I want to ask her one more question. If LINks are so very diverse, will they not be very confusing to the general public? They are confusing to us so what on Earth will the general public think of them?

Baroness Andrews: I do not think that they will be confusing. We are at the stage at which they look confusing because we do not have these animals operating in front of us. Once the host is contracted and the functions of the LINks networks are described, people will have a clear idea that across their local area there will be a network or alliance of people who know and care about health and who are expert in it; it will be their job to give the community's views on health services. That can be described in a fairly straightforward way. I agree that some of the organograms that we have had defy that. I am sure that when you state what the objectives are, people will understand.

Earl Howe: I am sure that Members of the Committee are most grateful to the Minister for having covered the amendments in such detail. This is a mixed bag of amendments so I suppose that it is not surprising that we should take comfort from some parts of the Minister's answer and less comfort from other parts.
	I was encouraged by what she said about Amendment No. 238KF, and I thank her for agreeing to take the idea away. I was sorry, however, that she confirmed my suspicions that a LINk would be unable to make reports and recommendations to national bodies. In some circumstances, a LINk might feel justified in reporting to that level. These are matters to which we can no doubt return if we wish at a later stage of the Bill. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.
	[Amendments Nos. 238KCA to 238L not moved.]

Lord Low of Dalston: moved Amendment No. 238LZA:
	Clause 222, page 154, line 43, at end insert
	( ) enabling people to monitor and review the provision of care services and local care services for persons moving their place of ordinary residence into the area.

Lord Low of Dalston: Never mind the opacity of parliamentary draftsmanship; the numbering of amendments that I have come back to from three weeks away in the States is mind-boggling enough. Noble Lords will see that Amendment No. 238LZA is grouped with Amendment No. 245B, which adds a new clause to Part 16, which deals with miscellaneous provisions. Both are probing amendments. Although they relate to distinct parts of the Bill, they are closely connected and, with the Committee's agreement, I will speak to them together.
	Hundredspotentially thousandsof disabled people are being prevented from moving home or moving from residential care to independent living each year because of bureaucratic delays and disputes about who should pay for their care. The root cause of these problems is the definition of someone's place of ordinary residence. This is a means by which local authorities and primary care trusts determine which authority has responsibility for personal support for disabled people who live in their area. Local authorities are responsible for assessing the needs of and providing social care to people who are ordinary residents within their area. However, it is quite common for one local authority to place someone in registered accommodation within another local authority's area. Under these out-of-area placements, it is the placing local authority that pays for the personal support costs. If the individual then decides to move into more independent accommodation, their place of ordinary residence is deemed to have changed to where their new accommodation is located. The local authority should then take responsibility for their assessment and for funding personal support. However, there is no legal definition of ordinary residence and the guidance is unclear. The Department of Health said that it would update the guidance in 2004 but has not so far done so. Some local authorities are using this confusion to delay or avoid paying the costs of the care of those for whom they should be responsible.
	Situations in which disputes about ordinary residence arise include the following: first, when someone is funded as an out-or-area placement in a care home that ceases to be registered as a care home; secondly, when someone funded out of area leaves a residential college but wishes to stay in the vicinity of the college; thirdly, when someone receiving support to live in the community wishes to move to another authority area, perhaps just a mile or two away; and, fourthly, when someone who is assessed by a local authority moves to a home in another area on a self-funding basis and within a few weeks or months approaches the original authority for help with funding. I have been personally made aware of another complication in my role as chairman of RNIB, in respect of which I of course declare an interest. RNIB's Rushton School, which is now located near Coventry, receives numbers of children who are placed out of area from diverse regions of the country. Their educational and social care costs are met by the placing authority but for some reason Coventry PCT is expected to pick up the bill for the healthcare costs of all the children from around the country. These situations have major implications for local authorities. The current system creates clear winners and losers. Some local authorities have very few residential care facilities and therefore make a lot of out-of-area placements. Others are well served by residential care facilities and therefore receive a lot of out-of-area placements.
	There are perverse financial incentives for placing authorities to encourage disabled people living in registered care homes to move into the local community, or to encourage homes to de-register so that they no longer retain financial responsibility for their clients' personal support costs. Those authorities in which large numbers of people have been placed face a significant increase in the numbers of disabled people needing support, with consequent budgetary implications. It is therefore essential that arrangements are put in place to ensure that these funding inequalities are resolved. Giving LINks the task of monitoring and reviewing provision in this area would help to give a voice to those stuck in the middle of these inter-authority disputes, many of whom are among those least able to make their voices heard. This is the purpose of Amendment No. 238LZA.
	Amendment No. 245B seeks to put in place a mechanism for arriving at a more systematic approach to resolving these problems. The Voluntary Organisations Disability Group, in a recent report entitled No Place Like Home, urges the Department of Health to take three urgent steps. First, to establish and enforce the principle that a person should receive appropriate social care and support from the authority where they are currently living or wish to live, regardless of circumstances. This would not deal with the Rushton problem, to which I referred, where the issue is one of disproportionate costs falling on a single authority because it happens to have within its boundaries a facility with a significant out-of-areafor example, national or regionalcatchment. Perhaps a better way of putting it might be to say that it is a fundamental principle that the ability to change one's place of ordinary residence should not be contingent on health or social care needs.
	Secondly, guidance to social services and PCTs should be updated to ensure that they implement this principle in a person-centred way that removes barriers to choice and independence. Thirdly, a framework should be put in place for the transfer of funds between authorities so that the issue of ordinary residence can no longer be used as a basis for refusing to provide care and support.
	I hope the Minister will be able to give us some indication of the Government's approach to these matters, and how they propose to disentangle the intricacies to which they give rise. It cannot be doubted that there is a range of knotty problems overdue for solution here. If the Minister does not have an immediate answer, perhaps she would agree that it could be beneficial to meet with local authorities and the other bodies involved in providing social care and health services, with a view to finding a way forward that commands general assent. I beg to move.

Earl Howe: I support the noble Lord, Lord Low, very strongly in all that he has said on these amendments. In doing so I declare a non-financial interest as president of the National Society for Epilepsy, a charity that regularly finds itself entangled in exactly the kind of sterile and time-consuming arguments to which the noble Lord has so correctly referred. I hope that the Minister will be sympathetic to the issue and will do all she can to expedite a satisfactory outcome.

Baroness Neuberger: I also support all the words of the noble Lord, Lord Low. I declare an interest as a former trustee of Jewish Care, where precisely these issues came up time and again. I very much hope that the noble Baroness will be able to do as much as she possibly can to resolve this issue, which has been going on, to my knowledge, for the past 30 years or more.

Baroness Howarth of Breckland: I support the noble Lord, Lord Low, and congratulate him on his ingenuity in bringing this extraordinarily long-standing difficulty to the House through this amendment. I doubt whether the noble Lord thinks that the Minister can solve this, but if she could move it forward in any way, she would help the lives of thousands of people.
	When I was a director of social services, well over 20 years ago, this was a central problem. It is not the wish of the local authorities to continue, but they have a responsibility to make their money go as far as it can. The regulations are not clear. If there was clarity it would make an enormous difference. I declare an interest as the chair of Grooms-Shaftesbury. It was very involved in the Voluntary Organisations Disability Group's report, which the noble Lord, Lord Low, outlined with such clarity that I do not need to go into further detail. The Minister could almost make her nameif she has not alreadyif she could take this forward.

Baroness Morgan of Drefelin: In making my name, I should say that it is Baroness Morgan speaking; my noble friend Baroness Andrews is taking her seat for a moment. I congratulate the noble Lord, Lord Low, on his ingenuity in bringing forward this amendment in this way and, perhaps more so, on speaking so eloquently and with great knowledge and depth of understanding about what is an extremely important issue, as he always does when he brings these issues to the attention of the House. I particularly congratulate the noble Lord on highlighting a potentially very positive role for the new LINks in a future where they could be responsible for championing this key issue.
	I understand that Amendment No. 238LZAthese are amazing titles for amendmentsseeks to ensure that LINks have an overview if, for example, a local authority wants to move someone to care home outside the area, or indeed if someone wants to move from one local authority area to another. They should have the right to social mobility.
	I can confirm that the activities of a LINk, as they are described in paragraphs (a), (b), (c) and (d) of Clause 222(2), apply to care commissioned and provided to people moving their place of ordinary residence into the area. The definition of local care services given in Clause 222(5) relates to care services provided in the authority's area and care services provided in any place for people from that area. Therefore, anyone living even temporarily within a given local authority area should be able to share their experiences of care services with the LINk for that area, even if the services they receive are from outside that area. Any healthcare commissioned by the PCT will fall under the remit of the corresponding LINk, even if it is provided in, for example, a prison. I know we are going to talk about that later.
	Turning to Amendment No. 245B, I understand that this amendment is a means to secure social mobility, or to raise the issue of it. Local authorities should be under a duty to co-operate in, for example, the sharing of needs assessments to facilitate and speed up payments if people move from area to area. I thank noble Lords for highlighting these issues around the question of mobility for disabled people and local authorities' responsibilities in this area. I agree that these are extremely complex and important issues and that they merit more detailed examination. I shall be pleased to take away the points raised by noble Lords today and will ask the Department of Health to discuss them with key organisations, as the noble Lord, Lord Low, has suggested. I know, for example, that the Voluntary Organisations Disability Group is particularly keen to meet to discuss these matters. I shall recommend that such a meeting takes place and shall be happy to bring pressure to bear in that regard or at least, for noble Lords who are discussing the issue here today, to press for significant progress to have been made before Report. With that in mind, I hope that the noble Lord will consider withdrawing his amendment.

Baroness Howe of Idlicote: Before the Minister sits down, perhaps I may ask her one question. If a LINk in a local area is so persuasive about certain provisions that need to be made that, in its wisdom, the local authority decides that more of its finances should go in that direction rather than in the direction that I would heartily supportas I support the amendment of my noble friend Lord Lowwould that mean that, with so many different priorities in each area, the situation would get worse rather than better?

Baroness Morgan of Drefelin: The objective in agreeing to take away and consider these amendments is to promote an outcome that will result not in further complexity or in things getting worse but in a situation where local LINksthe matter before us nowwill be able to champion the needs of the people in their area, particularly disabled people who want mobility. That is what we are talking about here. The noble Lord, Lord Low, has highlighted the complexity involved. We have to look at that carefully and come back with some practical, simple and straightforward suggestions.

Lord Low of Dalston: I am extremely grateful to the noble Baroness for her very positive response to the points that I raised and to those endorsed by other noble Lords who have spoken, for whose support I am also grateful. I thank the Minister for making it clear to me who was responding to the debate, although, having sufficiently made her name already, that was hardly necessary.
	The noble Baroness is absolutely right that, essentially, I was drawing attention to the complexity of these issues, and no one would expect an instant solution this evening. I am most grateful that the Minister has recognised and taken full delivery of their importance, that she has undertaken to look at them with the department to see whether they can be unravelled and that she has agreed to meet the voluntary organisations, disability groups and others involved to see whether, as I suggested, a way forward can be found. For all that, I am most grateful to her and I happily beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Baroness Neuberger: moved Amendment No. 238LA:
	Clause 222, page 155, line 4, after consult insert members of Patients' Forums and

Baroness Neuberger: I shall speak also to the other amendments in this group. The most distressing thing in all the discussions about the establishment of LINks has been that patients' forums have not been consulted or involved in the change. They were not part of the original group that Harry Cayton set up and they have been sidelined. Even the doctor-patient partnerships, which are moving towards LINks, have not been listened to adequately over their concern that the pace of the change is too rapid.
	In private meetings, the Minister has assured me that the Government are very grateful for all that patients' forum members have done. I suggest that it would be a concrete sign of that recognition if those members, or at least some of them, were consulted when the regulations for the new LINks system are drawn up.
	In Amendment No, 238LB, we suggest changing the wording to such other persons to be consulted about the regulations, because such other can include those who know how all this might work. It might, for example, include present patients' forums, as well as special interest groups, the national association for patients' forums and the local involvement network hosts. If that wide group is not consulted, huge doubt must remain as to whether full account has been taken of the implications of LINks and what they are to be asked to do. Our general concern about the lack of clarity of purpose, rather than about the process, has not yet been put to rest, and that is why we have put forward these amendments. I beg to move.

Baroness Andrews: I shall address the issue of the regulations because it involves a slightly narrower interpretation than that made by the noble Baroness. I shall then say a few words about how we want the expertise and commitment to continue working. I understand the noble Baroness's concerns and I hope that I can reassure her.
	The power to make regulations set out in subsections (3) and (4) already requires the Secretary of State to consult such persons as he considers necessary. However, it is important to state that there is no intention of using these regulations in the near future. The power to make regulations has been taken simply to ensure that LINks activities can be kept up to date in the future. For example, if health and social care services change perhaps with the announcement of major reformswe want to ensure that LINks have enough flexibility so that the effectiveness of their activities is not restricted. We said that forums are now ill-suited to meet the changes because there needs to be a wider, more inclusive network, but what we have learnt from patients' forums is very valuable and we certainly do not intend to lose that knowledge.
	The regulation-making powers are unlikely to be used soon, and patients' forums will no longer exist if and when regulations are made to add to the powers of LINks. Amendments Nos. 238VB and 238VC seek a similar end when regulations are made detailing the duties of service providers to respond to requests for information made by LINks. Again, the Secretary of State must consult the members of patients' forums.
	We shortly intend to make regulations on how service providers should respond to LINks, unlike the regulation-making power in Clause 222. We intend to draw up draft regulations and, in the next few months, will begin a full three-month consultation on the various powers, such as the power to review or to request information. It is absolutely our intention that that consultation should involve important stakeholders from many sectors. Many people who are interested in how LINks will work will have valuable opinions, and we do not wish to make patients' forums a statutory consultee because we do not think that the consultation should be limited to that group. It would seem unwise to retain them as statutory consultees once they were abolished, but they obviously contain important expertise.
	The transition to the new system will be evolutionary. It is a new system and that is part of the argument for the way that things are being done. It is a new system rather than an amendment of the old system. As we say in the document on making effective LINks, there is no reason at all why forum members, as part of LINks, cannot continue to build on the often positive relationships that they have formed with specific NHS trusts, which, in many instances, have been valued on both sides. Specifically, LINks members will be able to form specialist sub-groups focusing on areas that include hospital trusts, mental health trusts and so on, as well as focusing on LINk-wide commissioning issues at PCT or local authority levels. That will build on best practice.
	I firmly believe that many people who have built up relationships and trust with those organisations will want, and need, to continue to be involved. Therefore, not only will they be consulted in respect of what the noble Baroness raised in her amendment but they will have a role in making LINks, and the flexibility in the system, work according to the good sense and interest of the institutions. I very much hope that patients' forums will take that message in the spirit in which it is meant. We need the expertise and commitment to continue, and I very much hope that it will.

Baroness Neuberger: While I quite understand why the Minister does not necessarily want the present system of patient forums to be among the statutory consultees, will she assure the Committee that, where regulations are being consulted on in the next few months, she would expect patient forums to be consulted, even though they need not be statutory consultees?

Baroness Andrews: I am sure that we would want to draw the widest possible consultation and I cannot see any reason why that should not be the case. I will write to the noble Baroness about that.

Baroness Neuberger: I thank the Minister for that assurance, which is helpful. If that is the case, it will give members of patient forums considerable reassurance. I also thank her for the rest of her clarification, but we are not yet entirely on the same page here. There is still extreme concern among your Lordships about the transitional arrangements and how they will all work. Nevertheless, as the Minister has given me some assurance, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.
	[Amendment No. 238LB not moved.]

Earl Howe: moved Amendment No. 238LC:
	Clause 222, page 155, line 4, at end insert
	(4A) The Secretary of State shall make payments to each local authority that are, in the opinion of the Secretary of State, sufficient to cover the costs incurred by that local authority in making contractual arrangements specified under subsection (1).
	(4B) Nothing in this section shall prevent a local authority making contractual arrangements under subsection (1) so as to ensure that the activities specified in subsection (2) are carried on to a greater extent than would be the case if the arrangements were to cost no more than the payments made available under subsection (4A).

Earl Howe: I shall speak also to Amendment No. 238N. It was perhaps inevitable that, at some stage in these proceedings, we should come to the vexed subject of money. Through this amendment, I want to raise a number of questions for the Minister about the resourcing of LINks.
	We understand that funding is to be made available to local authorities by the Department of Health to enable the host organisations to support LINks and their activities. If, as I imagine, that funding is not to be ring-fencedthough the Minister may correct methe obvious question arises about whether the activities undertaken in a local authority area in the name of patient and public involvement will be adequate in any given case. If it is open to local authorities to apply money intended to support that involvement to other activities altogether, we have the prospector, at any rate, the possibilityof LINks being supported on a mere shoestring and, therefore, not being able to do their job properly.
	We will be debating the role of the Commission for Patient and Public Involvement in Health in later amendments, but one signal advantage of the commission is that the money that it distributes to forum support organisations cannot be used for purposes other than those for which forums were established. Under the arrangements in the Bill, however, there is no guarantee at all that money intended to support the activities listed in Clause 222 will actually reach the front line. It would be possible for a local authority to say that it was delivering the activities in the Bill when, in reality, those activities were so minimal that they were hardly worth the name of patient and public involvement. What steps could be taken, in those circumstances, to ensure that such involvement in health and social care is delivered properly? The answer is not clear from the Bill.
	Another aspect to this issue is that, if LINks are going to assume different forms and guises in different localities, it is axiomatic that the level of activity that they undertake is going to vary from area to area. That will not only be because the activities themselves naturally give rise to a different burden of work in different parts of the country; it will also reflect the size and composition of the LINks, which may be large and diverse in one area and thin and perhaps weak in another. The amount of money directed toward PPI in any given area has to be based on a reasonably objective and dispassionate assessment of what that area needs in order for the job of PPI to be done properly and effectively. This is not to advocate the conscious overfunding of LINks that may be a bit thin and weak. My point is that the budget for the host contract has to be arrived at on the basis of what is, and what might be, needed to deliver desired outcomes.
	How is that aim to be achieved? Again, the Bill is extremely vague and uninformative. What considerations will underpin the process whereby a local authority judges that funding of a host for a given year should, let us say, go up? If it reaches such a judgment, what factors will the Department of Health look to if it is to persuade the Treasury that additional funding should be provided? Whatever process is employed here needs to be transparent and fair, not least as between different parts of the country.
	I would be grateful if the Minister could shed some illumination on those issues. Also, what total amount of funding has been earmarked by the Department of Health for patient and public involvement in 2008-09 and any subsequent years? Is it less or more than the amount currently granted to the Commission for Patient and Public Involvement in Health, and how has the budgeted amount been arrived at? Does she believe that more funds will find their way to host organisations than currently goes to forum support organisations and, if she does, how much more money will there be?
	I hope that the Minister will be able to give us at least a measure of reassurance that there will indeed be a budget comparable in size to the present one and that the effect of all these changes is that we will see worthwhile amounts of money released to the front line, as adumbrated in her letter to noble Lords of 9 July. I beg to move.

Baroness Neuberger: While I support everything that the noble Earl, Lord Howe, has said, I will speak specifically to Amendment No. 238SA, which would insert a new clause about the employment duty for LINks. The reason for the amendment is that some 10 or so days ago the noble Earl and I went to see the Minister in another place, Ann Keen. It was a new innovation to be asked to see the Minister together, rather than our separate parties being seen separately. At that meeting, we raised the issue of employmentwho decides whether a LINk will be able to employ people and at what point. As yet, I have not been fully satisfied on that point.
	In discussion with Ministers, we have been assured time and again that a LINk will ultimately be able to employ people, even though the contracts may be held elsewhere. We have also been told that that will not be the case yet, because at the moment the host will do that at the setting-up stage. I would like the Minister to assure us that LINks will be able to employ peopleshe might already have said thatand perhaps when this will be so. Indeed, will contracts have to be held elsewhere, by the host, say, rather than by the LINk itself? That would be a considerable clarification, along with reassurance that there will be adequate money available to do it all.

Baroness Howe of Idlicote: I have added my name to two of these amendments. If I may say so, I thought that the questions asked by the noble Earl, Lord Howe, were absolutely spot on. I want to probe a tiny bit further on the point about ring-fencing, which is important. If we had assurances on that, we would have rather more confidence in what is being proposed. What will be the basis of the funding? Do the Government intend that there will be a careful look at the residents of a particular area, and their needs, quite apart from the needs that are being spelt out as the LINks get under way? It would be important to know that.
	Another thing that worries me slightly is what happens if there is a fallout between the host and the LINk and they do not agree about what is being donethe host may not much want to endorse it and might get a bit critical that what it hoped for is not being achieved. Those are the sort of things that I hope are being looked at and thought about. These will be opinionated groups with all sorts of different priorities, which will not necessarily be acceptable either to the host or to the local authority. There are some problems, which, presumably, the Government are thinking through.

Baroness Howarth of Breckland: I have three simple questions. First, what advantage does the host have in carrying out this duty? Secondly, will it be able to levy a management charge? Thirdly, if so, how will that be controlled by the local authority so that as much money as possible goes to the front line? I have totally forgotten what the next question was, so I apologise. No, I know. It is about power sharing. Clearly, if a host is going to undertake this, it might be doing so for financial gain or for influence. Will the guidance ensure that there is a wide diversity of interest, rather than a narrowness of interest held by a particular host?

Baroness Andrews: None of the questions that noble Lords ask is simple. I am sorry that the noble Baroness remembered the other question, although the first one was actually worse.
	Perhaps I may briefly go over the process. We think that giving local authorities the duty to establish LINks for procurement of hosts fits very well into the whole notion of devolution of power to local authorities in the Bill. It is right that this provision should be at local level and not delivered from a central body, which is exactly what we do not want to do.
	I have to resist for predictable reasons the proposal to put in the Bill a requirement on the Secretary of State to ensure that sufficient funds are available to cover the costs of a local authority and its work to put in place contractual arrangements to enable the establishment of LINk activities. As noble Lords know, the intention is that the Secretary of State will make a grant to each local authority to enable it to procure a host organisation to support the LINk and to fund its activities.
	Although the exact amount of these grants is still subject to the Comprehensive Spending Reviewa mantra that is being echoed across all government departmentswe have said that the total amount available for the new system of LINks should be equal to what is currently spent on patient forums. The noble Earl asked whether the amount of money will be comparable. The answer is yes. That will initially take the form of a three-year grant. It is not ring-fenced. There is nothing perverse in that. It is not ring-fenced because we have moved away from the ideology of ring-fencing. Indeed, the whole notion of local area agreements, to which we are moving in the Bill, is to have flexible pots that can enable services to support each other and draw on a much more coherent and explicit form of support.
	The funding will be explicitly targeted to ensure the purpose of making arrangements to establish a LINk. This will be visible; it will be discrete; and I am sure that it will be observed. In making the grant, the Secretary of State will assess what levels of funding will be necessary to cover the costs of each local authority. Obviously, this must be grounded in local realities. I hope that the noble Earl is reassured when I say that we are working with local authority representatives as well as with the Local Government Association to determine realistic budgets that will cover costs associated with administering and monitoring contracts. That will vary according to the nature of the area. Size is clearly a factor. Birmingham will have a very different set of requirements from those of a unitary authority such as Thurrock.
	The amendment of the noble Earl seems to present an irresistible argument, but I must resist it because, if I were to give in, it would be customary from here on to have a passage in every piece of legislation stating that funding would be sufficient. That then raises the question of who would be the statutory judge of whether the funds were sufficient. We are entering a minefield here. The Secretary of State will consider how much each local authority needs and will make a judgment as to the level of funds necessary, informed, as I have said, in these different ways about how the local authority can comply with its duty. The factors will be demographicthe nature of the population and the size of the area. I hope that that will meet the criteria of fairness, because it will certainly be a transparent process. We want LINks to work. We are not setting them up to fail. We want them to be as effective as possible.
	Proposed new subsection (4B) aims to allow local authorities to spend more on making contractual arrangements than the allocation provided for by the Secretary of State. That is a very important suggestion. Equally, it is very important that arrangements for LINks should allow for the possibility of additional funds being available from whatever sources exist. There is nothing in the Bill to prevent local authorities from making additional funds available for LINk activities. If, for example, they wanted to add to funding for LINks from their own engagement activities, I could see that there would be an argument. In the Bill, local authorities are under a duty to involve, inform and consult local people. If we can get some synergy, there may well be some possibilities.
	Amendment No. 238N is difficult to understand. It seems to take away a fundamental plank in the process of establishing a LINk; that is, the power for a local authority to make payments to a host. I am not sure whether I have missed something very important or subtle, but I cannot see any benefit in removing that provision because, as I have said, we think that it is vital that a host is created.
	Amendment No. 238QA seeks to ensure that the arrangements that the local authority makes with the host provide that the LINk has the necessary staff, premises and so on. This is a logical amendment in relation to the earlier one. I do not believe that it is necessary because I think that the whole point of the contractual arrangement, which we set out in the model contract, is precisely to state the types of support that the host is expected to give the LINk. It could be minimal, it could involve staff, support and premises, but it will vary. Every contract must reflect local realities. We are issuing a model contract specification. It is not mandatory but it is a guide to help tailoring in local circumstances. The local authority will be under a legal duty to make contractual arrangements with a host to ensure that LINks activities can be undertaken. The safeguard is there.
	On Amendment No. 238SA, the noble Baroness asked whether it will be possible for LINks to employ their own staff and decide such issues as pay and so on. I can certainly give her an assurance that it will be possible, as the provisions already allow for a LINk to be any sort of body, including one that can employ its own staff. I am thinking of companies limited by guarantee or charities with employment status.
	A more difficult question is when. It is difficult to say, because in some instances the contract could be held by the host immediately, but it would be explicit from the start that the LINks would want to do the employment. It would be in the nature of the contract. There will be LINks organisations that will grow in confidence and that may feel a year or two into the scheme that it is right for them to take over the employment functions. The provision has to be as flexible as that. I cannot see a problem with that. I do not think that we would want to prescribe this. I shall look at the matter again and come back to the noble Baroness if I think that there are ambiguities.

Baroness Neuberger: The noble Baroness has just suggested that a LINk might be able to employ staff immediately. Is she suggesting that a LINk might become a company limited by guarantee or a charity with employment status at the very beginning of its existence? It is important for us to know that for the rest of our discussion about LINks.

Baroness Andrews: It will not obviate the need for a host. There will always have to be a host. Until I receive more intelligence from the officials, I shall have to busk on this one. In the mean time, I will move swiftly on to answer another question.

Baroness Howarth of Breckland: In the light of the answers that have been given, and the fact that this is a financial issue, perhaps I may ask the Minister a question. She said the organisation could be a charity. If these LINks become charities, will have the same status as other charities in their area and therefore be able to raise funds externally? Will they therefore be in competition with all the other charities, although they are delivering what has previously been a statutory function for things like the lottery? If this has not been thought through, can it be thought through before it becomes an issue?

Baroness Andrews: If they are a charity, they will have the freedom to do that. In terms of the impact it would have on the pattern of local provision, in the voluntary sector we are nearly always in the situation of competing against our best friends. That is part of the negotiation procedure. I will think about what the noble Baroness has said.
	With regard to the noble Baroness's other question, we see no reason why this should not happen straightaway. But given the embryonic nature of the organisations, it is more likely that they will want to wait until they have established their raison d'tre, until their scope is determined and their priorities, agendas and working programmes set up. But we will have to wait and see.
	The noble Baroness asked what would happen if hosts and LINks fall out. I cannot imagine that that would ever happen, but LINks will have the opportunity to put their views and concerns directly to the local authority. The contract has got to be deliverable; if LINks finds that its host organisation is doing something that disables it in some way, it would be right and proper for it to go to the local authority and say, Look, this contract is not being managed in the way it should be. That is part of the performance management built into the situation.
	I have answered most of the questions. It is worth reiterating that this legislation is very permissive and we need to preserve in the arrangements for LINks the duty of the local authority to take a view as to what is necessary. We are talking about minimal levels of support, or it may be a sophisticated arrangement that will either be designed in or will emerge over time.
	I have a note asking whether local authorities will be able to produce some grants to pay for the costs. This refers to management costs. We have already discussed this with the Local Government Association and we trust that local authorities will take a fairly mature view of it. We will come back to this point and will look at the legal implications of that.

Baroness Masham of Ilton: While the noble Baroness was answering, I thought of one more question. If local authorities hold the money, will they not give priority to local authority projects rather than health needs? There will be so many demands.

Baroness Andrews: The point is that the local authorities will not hold the money; they will make the contract with the host, which will hold the money. It is that which guarantees the independence of LINks. The first amendment we discussed about why a host is needed clearly established the notion of independence, so that the sort of situation the noble Baroness describes simply could not happen.

Earl Howe: Once again, the Committee will be grateful to the noble Baroness for her reply. I am glad that work is currently going on with the Local Government Association on how a transparent and fair system of funding of LINks could be best established. That is good news. I am sorry that the noble Baroness could not go further and give the Committee some idea as to what levers might be pulled by Ministers or others to prevent a situation arising where the activities listed in Clause 222(2) are performed in only a minimal way as a result of inadequate funding in a given instance. Like the noble Baroness, I am no advocate of ring-fencing, but there are dangers when ring-fencing does not applythe obvious one being that the activities in question are not safeguarded
	Nevertheless, the noble Baroness has shed some useful light on this area. There are questions that remain open, the principal one being the quantum of money that will be directed to this area, which for obvious reasons she cannot be specific about at this juncture. But it was helpful to hear that it will be comparable to the sum currently directed towards patients' forums and we can take comfort from that. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Baroness Masham of Ilton: moved Amendment No. 238LD:
	Clause 222, page 155, line 4, at end insert
	( ) For the avoidance of doubt, arrangements under this part apply to the provision of care services and local care services in prisons, secure training centres and young offender institutions.

Baroness Masham of Ilton: In moving Amendment No. 238LD, I seek to see if LINks are going to operate in prisons and other penal establishments. The NHS now has responsibility for prison health. I quote from a statement made by my noble friend Lady Murphy:
	Prisons are like swamps providing the breeding grounds for the mosquitoes of disadvantage ... the revolving prison gate feeds further public health problems back into localised communities. If we are serious about narrowing the health inequalities of our most disadvantaged communities, prisons are a very good place to start.[Official Report, 10/11/05; col. 802.]
	Improving healthcare of prisoners can also have the positive effect of reducing and preventing reoffendinga key government target. Prisons have a cross-section of health issues and there is a vital need for good through-put in healthcare within prisons and good links with the communities they go out to if there are ongoing health problems. There must be suitable communication.
	One of the most difficult problems in prisons is the dual diagnosis of mental health and addiction. There are also sometimes other problems, such as sickle cell disease. There is a huge drug and alcohol addiction problem in prisons. It must be treated within prisons and links with the communities are needed so that rehabilitation can continue. All adult prisons now have CARATScounselling, assessment, referral, advice and through-care services. This is certainly an improvement, but health issues within prisons need more flexibility and working in co-operation with each other. Prisoners come into prisons very often and nearly always with no health records. Communication about their health needs improvement. Health facilities within prisons, such as the building of a treatment room, take a very long time to establish as the issue is surrounded by unnecessary red tape and bureaucracy. That frustrates prison staff when they know that there is money available.
	The Minister has stated today that if LINks ever come into being, they will help with a wider range of needs. Will prisons and other penal establishments be included in these ranges? I beg to move.

Baroness Morgan of Drefelin: I hope that I can reassure the noble Baroness and take this opportunity to put some points on the record with regard to the inclusion of prisons in the function of LINks. To make it absolutely clear: the function of LINks will be to gather the views and experiences of people in their area. It will be one of the roles of the host organisation to ensure that the views of all parts of the community are sought, and therefore LINks will certainly want to seek the views of prisoners and, for example, asylum seekers in detention centres on the health and social care services they receive or might receive. We want to encourage everyone in the community to become involved in LINks and ensure that a wide range of views are proactively gathered and fed in to those who commission and provide care services.
	On the specific amendment before us, I can confirm for the record that a LINk as described in Clause 222(2)(a) to (d) apply to healthcare commissioned and provided to prisoners. The definition of local care services is given in Clause 222(5) and relates to care services provided in the authority's area and those provided in any place for people from that area. Therefore, anyone living even temporarily within a given local authority area will fall under the remit of the LINk and should be able to share their experiences of the care services they have received with the LINk for that area, even if the services they receive are from outside it. Any healthcare commissioned by the PCT will fall under the remit of a LINk, even if it is provided in a prison.
	I hope, with that clear point on the record, that the noble Baroness will feel able to withdraw her amendment.

Baroness Masham of Ilton: I thank the Minister for that encouraging answer. She will be aware that in prisons there has been an increase in infectious conditions such as drug-resistant tuberculosis, which is a very worrying development. There is therefore a need for these health issues to be considered within the community, and I am glad that she said that. However, she did not mention the vast number of people who visit prisons, such as prisoners' families, prison visitors and so on. They are often left out, and they have problems such as timing their visits, travelling long distances and places to wait in when it is raining. There are many issues. But the Minister has been encouraging and therefore I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.
	[Amendment No. 238LE not moved.]
	Clause 222 agreed to.

Baroness Crawley: I beg to move that the House do now resume. In doing so, I suggest that the Committee stage begin again not before 8.32 pm.

Moved accordingly, and, on Question, Motion agreed to.
	House resumed.

Political Parties, Elections and Referendums Act 2000 (Northern Ireland Political Parties) Order 2007

Lord Rooker: rose to move, That the draft order laid before the House on 21 June be approved.

Lord Rooker: My Lords, at the end of 2005, the Government carried out a full public consultation on the issue of political donations in Northern Ireland. Their response to the consultation exercise was published in January 2006. It outlined a number of measures that were later given legislative effect in the Northern Ireland (Miscellaneous Provisions) Act of the same year. The Act is, as I am sure noble Lords are aware, the parent Act of the order before us today. Since it received Royal Assent in July last year, we have had a series of discussions with the Irish Government and the Electoral Commission on the detail of how the new donations arrangements in Northern Ireland will work, and the order seeks to give effect to those discussions. I am fully awareand indeed I am reminded of it as I read my notesof the concerns that some expressed about these provisions during the passage of the 2006 Act, and in the recent debate on this order in the other place, and I know that those concerns are shared by some noble Lords here today. Given that, I should like to set out the detail of the order in context as clearly as possible.
	Until now, the source of donations to political parties in Northern Ireland has been completely unregulated. The provisions of the Political Parties, Elections and Referendums Act 2000 which banned foreign donations and introduced a system of public reporting of donations in the United Kingdom were disapplied from Northern Ireland. Donations have been permitted in Northern Ireland from anywhere in the world and the Electoral Commission has not been notified about who donates what. This exemption was for what we considered to be sound reasonsconcerns relating to the possible intimidation of donors to political parties in the event of their identities being made public, and to allow Northern Ireland recipients to accept donations from Ireland in a manner consistent with the spirit of the Good Friday agreement.
	However, in 2005 we concluded that the time was right to introduce effective regulation of donations in Northern Ireland in order to inject some transparency into the system. The Northern Ireland (Miscellaneous Provisions) Act 2006 therefore made provision for political parties registered in the Northern Ireland register and regulated donees, known collectively as Northern Ireland recipients, to continue to be exempt from the provisions relating to the control of political donations which are set out in Part IV of the Political Parties, Elections and Referendums Act 2000 for one final period. Under Section 11 of the 2006 Act, that period of disapplication expires on 31 October this year. From 1 November, all of Part 4 of the 2000 Act will apply to Northern Ireland for the first time, but with two significant modifications. First, Northern Ireland recipients will continue to be able to receive donations not only from all existing permissible donors under the 2000 Act, but also from Irish citizens and prescribed Irish bodies. Secondly, Northern Ireland donation reports will be held confidentially and checked privately by the Electoral Commission for an initial period of three years, or longer if extended by order of the Secretary of State.
	It is worth repeating a point I made during the passage of the 2006 Act: these changes, whatever is said about them, represent a very considerable narrowing of the regime that exists at present. I should repeat that the present system allows Northern Ireland recipients to accept donations from anybody of any nationality resident anywhere on the planet. What is more, they do not have to report them to any regulatory body. Any move from that to introduce more transparency and a degree of regulation will represent a narrowing of the regime. The confidentiality arrangements in relation to Northern Ireland reports which are set out in the order are temporary. The Act provides that they will fall away in 2010, bringing Northern Ireland even further into line with Great Britain. Although the period is extended by order it is our firm hope that, when the time comes, we will not have to seek Parliament's approval to do so.
	The provisions enabling Northern Ireland recipients to continue to accept donations from Irish citizens and Irish bodies meeting prescribed conditions are contained in the 2006 Act and are, by contrast, permanent. This order simply puts flesh on the bones of Part 3 of last year's Act by setting out precisely what the conditions are, how the Electoral Commission may verify the source of any donation, and what steps it can take if impermissible donations are found to have been accepted. The provisions of the 2006 Act are in line with the original recommendations of the Neill committee which gave rise to the 2000 Act in the first place: that because of the special role of Ireland in Northern Ireland's political life, as set out in the Belfast agreement and elsewhere, it would not be right to ban contributions from there. In contrast to the position on confidentiality of donations, which as I have said we hope will no longer be relevant in 2010, we do not see any circumstances in which the recommendation in relation to Irish donations is going to lose its relevance at any point in the near future. For this reason, the measures in the 2006 Act and this order to meet this recommendation are not time-limited. But the order-making power in the 2006 Act allows us to vary widely, with the consent of Parliament, who should qualify as an Irish donor.
	As I have indicated, the order puts flesh on the bones of the relevant provisions and I will briefly summarise them. Part 1 of the order specifies the conditions which an Irish citizen must meet in order to be able to donate to a Northern Ireland recipient. It also specifies the categories of Irish bodies which will be entitled to donate to Northern Ireland recipients from 1 November onwards.
	Schedule 1 sets out the information which must be provided in relation to donations from Irish donors in donation reports from Northern Ireland recipients. The steps which the Electoral Commission must take in order to verify the information contained in the donation reports submitted by Northern Ireland recipients are set out in Part 2 of the order. The Electoral Commission must check 50 per cent of donations from individuals and 100 per cent of donations from bodies reported by Northern Ireland recipients. It may verify the information provided in the donation reports by, among other things, contacting the bodies listed in Article 11 to which it is able to disclose information. For example, the commission could contact the Northern Ireland Assembly Commission to verify information relating to payments made under the Financial Assistance for Political Parties Act (Northern Ireland) 2000 or could contact the Department of Enterprise, Trade and Investment in relation to companies registered in Northern Ireland.
	The commission is under a duty of confidentiality in relation to information contained in reports from Northern Ireland recipients during the prescribed period. However, the commission has the power under the 2000 Act, as modified by last year's Act, to release information contained in a Northern Ireland donation report if it believes on reasonable grounds that the donation was from an impermissible or unidentifiable donor.
	Article 10 sets out the requirements in relation to which such information must be released. The commission would release the amount of the donation and the party to which it was made but not the identity of the donor. This is in recognition of the fact there may be circumstances in which the publication of a donor's personal detailstheir name and addresscould lead to a threat to that individual's life.
	It was suggested in the debate in the other place that if this order was not passed the relevant measures in the miscellaneous provisions Act would fall away on 31 October. I stress that this is not the case. If this order fails to pass, the relevant sections of the 2006 Act would still take effect on 1 November this year; however, without the details of this order the new regime would not work effectively. For example, no provision would be made about the contents of donation reports which relate to Irish donations, and there would be no mechanism in place for the Electoral Commission to check both Irish and UK donations to Northern Ireland recipients during the prescribed period. This would mean that while Northern Ireland recipients would be required to submit donation reports in relation to donations from the UK and not those from Ireland, these reports would not be scrutinised properly. I am sure noble Lords agree that would be very undesirable.
	I should also like to clear up any potential misunderstanding concerning the issue of Northern Ireland parties being able to pass on Irish donations to their counterpart parties in Great Britain. There are two separate registers of political partiesone each for Great Britain and Northern Ireland. A party may be registered in both the Great Britain and the Northern Ireland registers, but in such a case it is treated as two separate registered parties. This was set out in the original legislation in 2000.
	New Section 71C of the Political Parties, Elections and Referendums Act 2000, which was inserted by Section 12 of the 2006 Act, further prevents parties registered in Northern Ireland making donations to parties registered in Great Britain or to regulated donees in Great Britain. The effect of this is that Irish citizens and prescribed bodies meeting the prescribed conditions will be able to donate only to parties registered in the Northern Ireland register. This means that there is no back door by which Irish donations can legitimately reach parties registered in Great Britain. They would be classified as foreign donationsit is as simple as thatand would be ruled out. That was the position established by the 2000 Act and the 2006 Act maintains that situation.
	I hope noble Lords agree that the order represents an important step towards aligning donation controls in Northern Ireland more fully with those for the rest of the UK and along the path to achieving full transparency. It does not duplicate what happens in Great BritainI fully accept thatand that is made clear throughout. It represents the principles of the Good Friday agreement by allowing donations from Ireland. I shall do my best to answer any questions. I beg to move.

Moved, That the draft order laid before the House on 21 June be approved. 21st Report from the Statutory Instruments Committee.(Lord Rooker.)

Lord Bew: My Lords, I am grateful to the noble Lord, Lord Rooker, for the characteristic and forceful way in which he has outlined the Government's case on this matter. Throughout the difficult debates over the past two years he has never gilded the lily and he has presented the facts to us in a straightforward manner. None the less, what he is proposing today constitutes, as he has said, a double exemption of sorts for Northern Irelandone temporary and one of longer-term significancefrom the normal UK electoral law.
	To deal first with the temporary exemption, which is perhaps of less deep significance, the Government had obviously hoped that by this point they would be in a position to remove confidentiality protection of the kind that exists in Northern Ireland electoral law and to have complete transparency along the lines of the United Kingdom. It is not the Government's fault that we are not quite at that point. The violence at the weekend in Carrickfergus reminds us of the ways in which Northern Ireland still, despite the enormous progress made, does not have the degree of stability and peace that there is throughout the rest of the United Kingdom. None the less, although the Government's position is understandable, the consequence of what has been said here today is that it is most likely that the next general election will be fought in a context in which confidentiality will apply to Northern Ireland electoral donations which will not apply in the rest of the United Kingdom. It is important to keep that in mind.
	More significant, however, is the Government's view on the question of allowing Irish citizens to contribute to Northern Irish political parties. This goes against the basic principle of exclusion of foreign donations in our mainstream UK legislation. Irish citizenship is defined in the Irish constitution extraterritorially; it can mean Irish citizens in Northern Ireland and Great Britain, but also in the United States of America. As the noble Lord, Lord Rooker, was honest enough to say to the Grand Committee in June 2006, there are a lot of Irish citizens around the world. This is opening a very wide door.
	I was quite surprised to see in another placeand to a degree repeated today by the noble Lord, Lord Rookerthe argument from the Government that opposition to or concern on this matter reflects a failure to grasp the core principles of the Good Friday agreement. The Good Friday agreement is quite correct; it gives a legitimacy to people who consider themselves British or Irish or both. However, this provision gives a legitimacy to those who consider themselves American or Irish or both. It is not quite in line with the Good Friday agreement; it creates in principle a new privileged type of donor. That argument surprised me when I first heard it, but the more I reflected upon it the more it surprised me.
	Since 1994 I have been a vigorous advocate of the principles of the Good Friday agreement. These principles today are accepted by all the parties in this House; they are acceptedwith a degree of reservation by some perhapsby 108 Members of the Northern Ireland Assembly; and they are accepted by both the British and Irish Governments. In 1994 this was far from being the case. Those of us who argued for it found ourselves often in a lonely place and often opposed, it would appear, by the majority in both communities in Northern Ireland, and certainly by the majority of the parties which currently dominate the Northern Ireland Executive. Now things have changed and I am very grateful for that.
	However, it is also remembering that in 1994 the Labour Party found itself in an ambiguous position on some of these questions, as indeed did the Irish Government. The argument for this legislation cannot be found in the Good Friday agreement, although it can be found in the broader logic of the peace process more generally. I am prepared to accept that. The Government would have been more honest with us if they had expressed themselves in those terms.
	In certain respects, though, the argument as presented today actually constitutes a regression from the key principles of the Good Friday agreement. One of the things the agreement does is remove the difficulties that arose from the 1985 Anglo-Irish agreement, which created an unhappy marriage between British and Irish constitutional thinking in which it emerged that, for example, a common-or-garden phrase like the status of Northern Ireland meant an entirely different thing in Irish constitutional theory from what it meant in British constitutional theory. It was not until 1998, thanks in part to the labour of noble Lords in this House todayI refer to the noble Lords, Lord Trimble, Lord Laird, Lord Kilclooney and Lord Maginnis, and othersthat eventually this matter was sorted out by the Good Friday agreement, the referendum that led to a change in Articles 2 and 3 of the Irish constitution and the victory of the principle of consent, the guiding principle now accepted by all which governs the politics and the future of Northern Ireland.
	The key point is that we are now regressing. On one hand we have a formula in the Irish constitution, extra-territorially defined citizenship, which is extremely broad and is something the British Government have no right to expect to be able to define. We are returning to the uneasy world of 1985 to 1998, when the British Government found themselves locked in to meanings that were defined by the constitutional text of another state. I almost said that we were returning to the dark days of Thatcherism in that respect. It would have been better if the argument had been made on a different ground; that is, on the ground of the broader logic of the peace process.
	I also think that the House has found it easier to accept the provisions because the party that is expected to benefit the most, Sinn Fein, does not appear in the House of Commons. We cannot assume that that will continue for ever. Such is the pace of ideological revisionism within Sinn Fein's political leadership that it is quite conceivable that it will appear in the Commons within the next few years, and should it do so, it would be a step that I would welcome. However, a consequence would be that, possibly in the context of a hung Parliament, a key group of MPswhich might decide the colour of the next Government, on the polls as they existed a month ago, if not todaywould be elected in the context of an electoral law totally different from that governing the other Members of that House.
	It is not enough to say that we can prevent transfers of money from Northern Irish parties to British parties. The consequence of this legislation goes further: it will create a different type of Member. So far that type of Member does not appear, but they may appear soon and that might affect how Governments operate. It is important to say that, because many of the concerns about Sinn Fein in politics and its financing have disappeared or been greatly reduced because of its relatively weak performance in the recent Irish general election. But although many noble Lords might devoutly wish it, the affairs and representatives of Northern Ireland cannot be kept in Northern Ireland.
	A Pandora's box has been opened here. I understand the reasons why the Government have decided to do it. There are justifications in terms of the peace process and of the process that has persuaded the Sinn Fein leadership to give up violence and endorse politics, which are overriding considerations, and the greatest justification of all is the saving of human life that has occurred as a result of that policy. In that respect the Government are on firm ground, but they should not hide from themselves that there is a downside and an ambiguity to what is taking place, to which we will have to pay attention over the years that follow.

Lord Glentoran: My Lords, it gives me great pleasure to speak immediately after the noble Lord, Lord Bew, has made his maiden speech. He is a compatriot of mine and, although not quite a neighbour, is in very close association. He has given us, in those short eight minutes, a clear demonstration of his capabilities. He is indeed a professor of Irish politics at Queen's, and has been part of Irish politics and all those things that have happened for probably the past 40 years. I sincerely hope that he will continue to attend your Lordships' House regularly and give us his wit, knowledge and experience of Irish politics. I hope also that he will open that into a wider field than just Irish politics. He is very welcome here.
	I return to the business of elections and referendumsin other words, party funding. My party, as the Minister made clear he understands in his clear outlining of the order, is not totally happy about what is happening. The Northern Ireland Office seems to have done a lot of work to fill one of the gaps I was worried about, which was that money could flow in from almost anywhere, as the noble Lord, Lord Bew, said. There are Irish citizens all over the world, and money could flow from them into Ireland and into the parties in Northern Ireland. However, it was new to me tonight when I heard it, although it probably should not have been, that money cannot flow out from Northern Ireland into England, Scotland or Wales. As a Conservative in Northern Ireland I am rather disappointed about that; I thought we might have pulled an advantage over the Government. I wondered why the Labour Party was giving serious consideration to setting up in Northern Ireland. I thought maybe it was joining us in having a way into this potential pot of gold. But it seems that is not to be.
	I am sad that parts of the order are permanent. I believe it will need reviewing again. Like the noble Lord, Lord Bew, I find it pessimistic that we are still saying we cannot do the same in Northern Ireland as we can in the rest of the United Kingdom because, because. We must grasp the issue. The Government have grasped it pretty well for a while, and we must not let them start slipping back from it on matters that might be a little uncomfortable. I see no reason why the disciplines should not be operated in Northern Ireland the same as they are here, or why Irish citizens should be allowed to fund Northern Irish parties unless they are clearly domiciled within the 32 countiesI can see some right in that. But there is no right in any Irish citizen holding an Irish passport being able to ship money from anywhere in the world through the Bank of Ireland into wherever. I hope the Minister will be able to tell me that the homework has been done thoroughly there, and that only those people who are registered on an electoral roll in the Republic of Ireland and are inhabitants and taxpayers thereof will be in a position to move money to parties in the north.
	Overall we support the bulk of the order, but there are loopholes in it that still need to be tightened up, and the permanence of some aspects of it are disappointing. I have a final question. In the Republic, can we ship money down to Fine Gael, Fianna Fil and the other political parties there? If the Conservative Party or the Labour Party wished to help to fund a campaign, or some of our wealthier membersI think there are more wealthy members on the government side than on our side these dayschose to help and support Fianna Fil for their own reasons, or political reasons, could they do that?

Lord Smith of Clifton: My Lords, I thank the Minister for his introduction of this order, and I welcome the noble Lord, Lord Bew. He was a colleague of mine as part of the wider Northern Ireland academic community, even if he worked for the other university.
	This situation is in a class of intractable problems, rather like the West Lothian question, and it will be with us for the foreseeable future. There are some unsatisfactory features, which all sides recognise, in these exemptions applying to Northern Ireland. There is a way we can contrive to deal with it. The Northern Ireland Assembly should have an upper Chamber, suitably adapted from the Celtic House of Druids, and people could buy their appointment to it by donating to the nearest parties and joining the legislature. We are trying to avoid that sort of thing here but we could nevertheless pass that on as a transitional experiment, which I commend.
	Only slightly more seriously, this continuing exemption is offensive for many of the reasons raised by the noble Lords, Lord Bew and Lord Glentoran. I have one question for the Minister. Article 3 of the order refers to someone being eligible to obtain an Irish passport, or certificates of nationality or naturalisation. That is a very loose, weasel phrase. Anyone can say, I'm sure I am eligible to obtain one of these things. This loose wording is most unsatisfactory. Will the Minister kindly explain how that will be tightly defined rather than being an open-ended mere gesture?
	Otherwise, with reluctance, we on these Benches accept, given the exigencies of Northern Ireland, that this exemption should be allowed. I agree with the noble Lord, Lord Glentoran, that I do not want these provisions to be set in concrete. We should review them in four or five years' time to see how things are working because we hope that by then, Northern Ireland democracy will have matured enough not to need these loopholes. Very reluctantly, we support the order.

Lord Trimble: My Lords, I offer my congratulations to the noble Lord, Lord Bew, on his maiden speech. It was delivered in a characteristically trenchant manner, displaying his considering knowledge and learning. Those Members of the House who had the privilege of hearing that speech will appreciate the extent to which this House will benefit from the noble Lord's presence and contribution in years to come.
	I entirely agree with what the noble Lord said about the Minister's pathetic attempt to say that this in some way can be derived from the Belfast agreement of 1998. It cannot. This flies against the letter and the spirit of the agreement. The noble Lord who made the assertions was unable, of course, to provide any justification for them. The agreement recognises the rights of individual persons to regard themselves as British or Irish but it confers no constitutional rights on them. Instead, in constitutional terms, the agreement explicitly recognises that Northern Ireland is part of the United Kingdom. It recognises the legitimacy of that; it even recognises explicitly the power of this Parliament to legislate and that that power is in no way untrammelled. It is quite wrong to say that that agreement gives Ireland a special place in the domestic affairs of Northern Irelandit does not. There is a special relationship through the North/South Ministerial Council and those arrangements, and that was the concession that we made to Irish national feeling. It is quite wrong for the Government to go further than that.
	The noble Lord, Lord Bew, is quite right that the approach taken by the Minister is a repudiation of the principles of the agreement and a regression to the worst things that went before. I feel very strongly about this matter; the House will have to come back to it again. The Government will have to stop being seduced by people offering some notion of the spirit or logic of the agreement. The agreement is clear, it has a text, and it ought to be respected. It is wrong for those who did not make the agreement to rewrite it in this wholly unacceptable way.
	The noble Lord, Lord Bew, said that he could accept this as somehow part of the peace process. Let me unpack that phrase. What that means is not the agreement and not anything derived from the agreement, but the manoeuvres that have been necessary to persuade paramilitaries to give up violence and enter into the political process. This peace process did so much damage to popular confidence in the agreement. It was because of this other process, quite apart from the political processes set apart in the agreement, that one saw the Government making improper concessions to those who had been involved in violence. I mean improper in the sense of not being justified by the agreement that we made, which is, or ought to be, the settlement of these things. From 1998, that agreement has been regularly undermined by the Government making concessions not justified by the agreement to those involved in violence as a means of weaning them away from it. In other words, it has been done as a result of a perceived threat from them. We should be long past this; we should not be back in this territory. I recall how a leading member of the Democratic Unionist Party said in 2003 that if one were to vote for that party on Thursday, the concessions would stop on Friday. Here we are in 2007, and yet another concession is being made to the men of violence. I hope that the noble Baroness who represents the DUP will tell us why it has acquiesced in yet another unnecessary concession to the republicans. I will not prolong my comments so as to ensure that she has the opportunity to do that.

Lord Laird: My Lords, I thank the Minister for outlining the order and add my name to those who have congratulated the noble Lord, Lord Bew, on his magnificent maiden speech. It is not a case of this House being a much better place and learning a lot from the noble Lord's contribution but that we in Northern Ireland are extremely favoured by having a man like him in this House. Northern Ireland and this House will gain by his presence here.
	I do not propose to dwell on the order too much except to say that I identify with a lot of the remarks made by the noble Lords, Lord Bew, Lord Glentoran and Lord Trimble. I am concerned about the special position that is constantly given to the Irish in the affairs of Northern Ireland. I have had experience directly from the Belfast agreement of dealing with Irish officialdom and it is not particularly pleasant. Unfortunately, in Northern Ireland we have allowed very low standards of Irish governance to come into our part of the United Kingdom, ensuring a lack of proper procedures in many important areas such as recruitment to public bodies. It is unacceptable and we should fight it on every possible occasion.
	Some people have exercised their minds over loans in the past few months, but where do loans come into the order? We have talked about donations, but I wonder how loans fit in. Can the noble Lord give me some idea about that? I understand about the need for transparency regarding donations in Northern Ireland but outside the remit of the order, there is a whole area that has to be further examined. A lot of money flows through to the coffers of Sinn Fein/IRA from illegal activities. Where is the money that was taken from the Northern Bank? Where is the 365 million per year lost to the Revenue by fuel laundering in Northern Ireland? Is that the money that backed up the election campaign which Sinn Fein ran in the Irish Republic and which, thank goodness, was a total disaster for that party and has perhaps set a new climate of opinion on the island of Ireland about the way forward?
	A lot more effort should be put into trying to stop the illegal flow of moneya massive amount of property is owned by Sinn Fein/IRA in the Irish Republicand its coming-across from its businesses into the election coffers on both sides of the border. I know that it is very hard to stop and I accept that it has nothing to do with the remit of the order, but we in this House should be very sensitive to it.

Baroness Paisley of St George's: My Lords, first, I congratulate the noble Lord, Lord Bew, on his maiden speech. Secondly, I say in answer to the noble Lord, Lord Trimble, that my party never gave any concessions to Sinn Fein, as he has accused us of doing. For the first time in its history, Sinn Fein has had to sign up to support the police. It has also decided to sign up, or was brought to the point of doing so by my party, to support the courts of law and order, which it had never done previously. We welcome that. We said that, if it signed up to those things, we would take the matter further. Sinn Fein wanted to sign up only to ordinary police, which would have meant paramilitary policing in its style, not policing as we know it, and we all know what that means.
	For the first time in at least 35 years, the police have been able to enter 100 per cent republican areas in Northern Ireland; they were never able to do that under previous Administrations. For the first time, Sinn Fein has welcomed the chief of police to the Falls Road, which we all know is a 100 per cent republican area. That was never done before. So I do not see where the concessions lie or where we have given in. We have brought Sinn Fein along and things have changed whether we like it or not.
	Even to my surprise, things have changed for the better in Northern Ireland. People right across the religious and political divide in Northern Ireland have witnessed that and congratulated us on it. People from England and other parts of the world who have previously visited Northern Ireland have seen the change, too, and we look forward to greater changes. We know that there will be hurdles and difficulties. We are prepared for them and will have to face them as they arise, but, at the moment, things are moving, slowly but definitely.
	I rejoice in the fact that Sinn Fein was beaten in the Republic of Ireland, which weakened its case in Northern Ireland. A united Ireland is further off now than ever before because of the rejection by the southern electorate of the IRA. It never expected that, as we all know. We will continue to fight for the rights of the people in Northern Ireland, for the defence of the police and, by them, of the courts of law and order.

Lord Rooker: My Lords, I congratulate the noble Lord, Lord Bew, on his maiden speech and welcome him to the House. His views are a welcome addition to the range of views that we hear in this House from Northern Ireland. I only wish that the range were wider. I do not know why the SDLP does not come here; I do not know why Sinn Fein does not come here. This House is a platform and a vehicle, and the place is available. The wider the opinion, the better it is. We always end up with these almost one-sided debates, although one gets a flavour of the different shades of unionist views.
	The noble Lord, Lord Bew, joins many practising professors in this place. They are gainfully employed. Everyone thinks that everybody in this place is retired. I have to tell my friends outside, You're kidding. They're out working and then they cut you to pieces at Question Time in the afternoon. That is why Ministers in this House are under greater scrutiny than Ministers in the other House. That is my honest opinion after six years here as a Minister. The noble Lord, Lord Bew, is very welcome.
	The noble Lord rightly said that no one can accuse me of sugar-coating the order. I have made no attempt whatever to hide exactly what we are doing, nor do I seek to do so. This is not a situation with which mainland political parties would be content in the long term, but one cannot divorce oneself from the fact that our relations with the Republic are different from those with other member states of the European Union, for example, on a range of issues.
	The noble Lord, Lord Bew, spoke about a hung Parliament and the other place being perhaps in the grip of a small group. I was in the other place from 1974 to 1979, towards the end of which we had a minority Labour Government. We worked very closely with our then colleagues in the Ulster Unionist Party to survive for a while. It would be unfair to say that we were held to ransom, but they cut a deal, saw their opportunities and who could blame them? I digress, but, as I have said, I have made no attempt to sugar-coat the order.
	I shall do my best to answer the specific questions, all of which were quite legitimate. The noble Lord, Lord Laird, asked about loans. There will be provisions for loans. They will be complicated. Frankly, we could not have done it in the order. We have changed the rules and we have changed the legislation on loans anyway. The provisions of the Electoral Administration Act 2006, which relate to the regulation of loans, have yet to be commenced for Northern Ireland, although they have already commenced for Great Britain. We hope to commence them later this year. We do not have to legislate; it is a question of getting a commencement order up and running. The legislation has been made. Northern Ireland was included, but the legislation did not commence there at the same time as in Great Britain.
	I go back to what I said earlier about the Neill committee, whose work gave rise to the Political Parties, Elections and Referendums Act 2000a very important piece of legislation, of which the Government can be rightly proud. The Neill committee, among other things, recommended that because of the special role of Ireland in Northern Ireland's political life as set out in the Belfast agreement, it would not be right to ban contributions from there. I shall go no further than that. There was another view of that issue.
	The noble Lord, Lord Glentoran, mentioned the Conservative Party organising in Northern Ireland. It is not for me to offer advice to the Conservative Party, but I think that it would be better off trying to organise in places such as Ealing Southall than bothering with Northern Ireland at present. I know that I should not have said that, but I could not resist it, because of the way in which the noble Lord raised the matter.
	However, the noble Lord made the fair point about the money flow. When the money flows into Northern Ireland from Irish recipients, it stays there. Therefore, for example, the Conservative Party of Northern Ireland, on a separate register, cannot donate to the Conservative Party of Great Britainlikewise the Labour Party and other parties. The money stays there. As a UK citizen on the electoral register, I can donate to parties in Northern Ireland. People in England, Scotland and Wales can donate to political parties in Northern Ireland.
	The question that arises is whether people resident in Northern Ireland can donate to political parties in the Republic, which is in effect a foreign country. It is not my job to answer that, because it is a matter exclusively for the Republic of Ireland's own legislative effect. I understand that such parties could donate to Irish parties if they had an office on the island of Ireland from which one or more of their principal activities are directed. I remember making this point when we discussed the Bill. But that is a matter for Irish legislation, as the regulation of donations to parties in the UK, including Northern Ireland, is a matter for UK legislation. We have discussed that with IrelandI made that clear in my opening speechbut we differ in aspects of the proposed law. I fully accept that.

Lord Glentoran: My Lords, I return to one pointthe cash flow from Conservatives in Ireland to Conservatives in the United Kingdom. If the Conservative Party in London decided to have all its election posters done, with the printing and material, under the auspices of the noble Lord, Lord Kilclooney, for example, or somewhere in Northern Ireland, and those accounts were paid by the resident Conservatives, where would we be then?

Lord Rooker: My Lords, I strongly suggest to the Conservative Party that if it does not know the answer to that it should go and have a chat with the Electoral Commission, because that relates to the operation of the GB register. However, as far as I know we are a United Kingdom and any business anywhere in the United Kingdom can do business with other areas. That is a business transaction. This is part of electoral law, but there should be a satisfactory answer that does not stop political parties organising themselves. That is not the intention. The intention is to stop money-laundering via the Irish route to Northern Ireland and to GB parties, because we do not accept donations from foreigners or foreign countries in Great Britainand that legally would be the situation.
	The noble Lord, Lord Smith, asked about the words eligible to obtain, which is clearly a legitimate question. The order is drafted to take account of the legal concept of Irish citizenship. Not to put too fine a point on it, it was not thought appropriate for us to legislate in the UK to dictate what status someone in Ireland should have. That is why the route is the other way.
	I shall explain how the checks will be done, because that will explain the position. What safeguards or checks will there be on Irish donors being entitled to donate to Northern Ireland parties? All citizens permitted under Irish law to donate to political parties in Ireland will have to meet the prescribed condition to be eligible to donate. That is, they must be eligible to obtain at the time of making the donation one of the three following documents indicative of citizenship: an Irish passport, a certificate of nationality or a certificate of naturalisation. It is not appropriate for us in the UK to legislate to dictate which one of those documents people should have or whether they should have it; all that we have laid down is that they should be eligible to obtain such a document.
	A certified copy of those documents must accompany the report in which the Northern Ireland recipient reports the relevant donation. In other words, the political party that reports the donation to the Electoral Commission must have a document stating that the donor was eligible to obtain a certificate of nationality, a certificate of naturalisation or an Irish passport at the time they made the donation. That would satisfy the rules; it would ensure that one has closed the groups of people who would be eligible for that. Those documentsthe Irish passport, a certificate of nationality or a certificate of naturalisationwould be certified by Ireland's Department of Foreign Affairs. That closes down the people who are not Irish citizens, or those eligible to be Irish citizens, in Timbuktu or anywhere else being able to shove money into Northern Ireland parties. The effect is the same as if we had legislated, which would have been considered improper, to say that they must hold one of those documents. That was agreed between the two Governments.

Lord Smith of Clifton: My Lords, I am not entirely clear on the eligibility criterion. I understand the point about people having a passport, a naturalisation certificate or a nationality certificate, but these days it is so easy to forge passports that I wonder how much easier it is to forge a statement of eligibility that one is entitled to one of these documents. I find that so loose and open-ended that, even given the Minister's best efforts at an explanation, I do not believe that he has answered my point.

Lord Rooker: My Lords, that document will be certified as genuine by Ireland's Government; for example, by the Department of Foreign Affairs in Dublin. I am not arguing about what is easy to forge and what is not easy to forge, but the Electoral Commission would receive details of the donation from the recipient in Northern Irelandthe political partyaccompanied by a certified document from the Department of Foreign Affairs that the donor was eligible to make the donation. In other words, they have to be eligible to make the donation in Ireland anyway, as that is where the constraint comes in. People who are not eligible to donate in Ireland are not eligible to donate in Northern Ireland. It is said that the check will be carried out by the Department of Foreign Affairs. I am happy to put that in a more detailed note.
	It is worth putting this next paragraph on the record. The Northern Ireland recipientsthat is, the partieswill have to provide the information set out in new paragraph 2A of Schedule 6 to the 2000 Act in donation reports from Irish bodies. In practice, in order to accept the donation and to provide the information required in new paragraph 2A, the Northern Ireland recipient will need to be satisfied that the body has an office in Ireland or in Northern Ireland from which one or more of its principal activities are directed and that the body falls in one of the categories prescribed in Article 4.2. That will enable the Electoral Commission to check both individuals and companiesit obviously deals with donations from registered companies. In other words, the donor has to be legitimate; it cannot be a front company. The company must have the wherewithal and the legal authority to donate in Ireland in the first place.
	People may argue about this, but this is a constraint on what happens today. I repeat that today political parties in Northern Ireland can receive money from any individual of any nationality, from any company, anywhere in the world without having to make a report to anyone about the amount of money received. Therefore, there is progress on that. This is not completely aligned with the United Kingdom, for reasons that I have explained, which we shall have to live with. I fully accept the point made by the noble Lord, Lord Bew, in his maiden speech that, come the next general election, people will be able to question legitimately from where the parties have got the money. There will be certain constraints about not being identified, but they will be free to make voluntary submissions about where the money came from. The fact is that there will be challenges about the money, which is quite legitimate in a democracy. We have set up a legal framework and we want it to operate fairly.

On Question, Motion agreed to.

Police (Northern Ireland) Act 2003 (Commencement No. 2) Order 2007

Lord Rooker: rose to move, That the draft order laid before the House on 6 June be approved.

Lord Rooker: My Lords, the order was debated in another place on Monday 2 July. The House will recall that during the passage of the Police (Northern Ireland) Act 2003 the Government made a commitment that, in view of the importance of the issue, this commencement order would be given full consideration by both Houses at the appropriate time. This approach reflected the importance of the provisions and that the timing of their commencement needed to be right. The context for tonight's debate is, of course, very different from that which existed at the time of the original legislation. I rely on that from the positive comments of the noble Baroness, Lady Paisley.
	Following the historic agreement to policing and the rule of law made by Sinn Fein earlier this year, there is now a firm foundation for stable devolved government and a new era for politics in Northern Ireland. We are confident that the Assembly will sustain the commitment it has already shown and continue to move Northern Ireland forward towards a shared future.
	There are, of course, many challenges ahead, not least the need to reach a decision on the devolution of policing and justice. We are pleased that the Northern Ireland Assembly has already established a committee to consider this issue, due to report by 27 March 2008. Work is now under way in the Northern Ireland Office to ensure that the policing and justice functions can be devolved by May 2008 should the Assembly request it.
	The progress on support for policing has been quite remarkable. Sinn Fein members having now taken their place on the Northern Ireland Policing Board, the prospect of inclusive policing supported by the entire community is at last a reality.
	A key element in the accountability architecture is the network of district policing partnerships throughout Northern Ireland. Since their establishment, they have played a unique role in building safer communities and empowering them to help shape local policing. The district policing partnerships have faced many challenges and I am sure that noble Lords will join me this evening in paying tribute to their work and the courage that many of them have shown in the face of threats and intimidation. District policing partnerships have made a positive impact on policing and, we hope, will continue to do soa view shared by the policing Oversight Commissioner and othersbut we need to build on this success, which is why we have decided to bring forward this commencement order.
	The Patten report recommended that both independent and elected members of the Policing Board and district policing partnerships should play a part in making the police accountable. The provisions we are now considering had their origins in the revised implementation plan of 2001, which the Government undertook to consider whether, in the context of a review of policing arrangements, the existing provisions in the Police (Northern Ireland) Act 2000 remained appropriate. The outcome of that review was published in the form of a draft Bill on 25 November 2002, together with text for consideration setting out how the Government intended to legislate in respect of district policing partnership disqualification and the powers of the Belfast district policing partnership subgroups. Draft clauses were subsequently introduced on Report of the Police (Northern Ireland) Act 2003.
	I have already indicated that we made clear that the commencement of these provisions would be by means of an order subject to affirmative resolution in both Houses. The Government believe that the time is right to commence these legislative provisions concerning district policing partnerships and the related district policing partnership provisions in the Northern Ireland (St Andrews Agreement) Act 2006. Our intention is that all these related provisions come into force on 4 September this year.
	The legislation before us this evening deals with matters relating to district policing partnerships and, in particular, arrangements for independent members' declarations against terrorism and disqualification. It also provides for the functions of the Belfast subgroups. The order inserts a range of provisions into the Police (Northern Ireland) Act 2000 and is, by its nature, complex. I will briefly deal with the main issues.
	Article 2 brings into force Section 15(1) to (5), Section 16(1) and Section 19(1) of and Schedule 1 to the 2003 Act. Section 15 brings the arrangements for independent members into line with those for political members. It requires them to make a declaration against terrorism in the same terms as prospective councillors before their application can be considered by the Policing Board. If an independent member appears to have acted in breach of his or her declaration against terrorism, it will be within the power of the Policing Board, or the district council with the approval of the Policing Board, to remove that person from membership of the district policing partnership.
	Section 16 amends the disqualification provision set out in paragraph 8 of Schedule 3 to the 2000 Act. The legislation provides that no one who has ever received a custodial sentenceregardless of how long ago or for what offenceshould be allowed to serve as an independent member of the district policing partnerships. The section changes that and provides that a period of five years must elapse following a person's discharge in respect of an offence before he or she may be considered for appointment to a district policing partnership. This provision is not new and brings the arrangements for independent members into line with the arrangements for political members of district policing partnerships, who are drawn from the local council. Similar arrangements apply in relation to appointments to police authorities in England and Wales.
	Section 19 and Schedule 1 deal with the arrangements within Belfast for the subgroups of district policing partnerships. Existing Section 21 of the 2000 Act requires Belfast City Council to establish a subgroup of its district policing partnership for each of the police districts within Belfast.
	The functions now proposed for the new subgroups mirror those for district policing partnerships in the 2000 Act. The Government believe that this should help strengthen the relationship between the local community and the police service of its area within Belfast. Article 3 provides for the commencement of Schedule 9 to the St Andrews agreement Act of 2006, which updates the provisions relating to the Belfast subgroups and takes account of the changes made to district policing partnership arrangements brought about by the District Policing Partnerships (Northern Ireland) Order 2005, which, as noble Lords will recall, made provision for the membership of district policing partnerships in the period immediately following a local government election. It also amended the law on the removal of members following conviction for a criminal offence and made a new provision about the chairmen and vice-chairmen of district policing partnerships. The commencement of these amendments is, therefore, linked to the commencement of the Belfast provisions in the 2003 Act.
	I have already indicated to the House that other district policing partnership provisions in the St Andrews agreement Act will commence at the same time as these provisions, but they do not require an affirmative resolution, although they play a key role and go hand in hand with this order. Schedule 8 to the St Andrews agreement Act provides for the reconstitution of district policing partnerships before the next local government election. This will enable members of Sinn Fein to take their political seats on district policing partnerships and allow the policing board to run recruitment exercises for independent members for the district policing partnerships affected.
	The board is to review the membership of each district policing partnership, and this must be completed within 15 days. District councils have three months following this review to appoint new political members of the district policing partnerships affected by the review. In line with the consideration and, I hope, approval of the order, the Government intend that Schedule 8 to the St Andrews agreement Act 2006 comes into force on 4 September. Commencing these provisions on this date provides the optimum timeframe for the reconstitution of district policing partnerships. From 4 September, the order will apply each time that the membership of a district policing partnership changes after a local government election. It will also apply to the one-off reconstitution of district policing partnerships under Schedule 8 to the Northern Ireland (St Andrews Agreement) Act 2006.
	We are well aware that this legislation has a direct impact on district policing partnerships and, in particular, on their members. I think that all of us in this House greatly appreciate the important role that the partnerships have played since their establishment and the undoubted commitment and courage shown by their members. However, the commitment of all parties and all communities to support policing and the rule of law now provides an opportunity to ensure that district policing partnerships fully reflect the communities they serveand we should not miss that opportunity. That is why we think that now is the right time to bring forward these provisions.
	I apologise for the length and detail of my speech, but it is important to get some of this on the record. I commend the draft order to the House. I beg to move.

Moved, That the draft order laid before the House on 6 June be approved. 20th Report from the Statutory Instruments Committee.(Lord Rooker.)

Lord Glentoran: My Lords, I thank the Minister again for his clarity and detail. He is absolutely rightit is all very important material to be debated, but, once again, we find ourselves in the Northern Ireland trap. I know that he agrees with me that this is a serious piece of legislation, it should be passed as a Bill, we should have plenty of time to debate it, turn it about, look around it, and so on. Once again, we are forced into a dinner-hour debate, we are running out of time and there is no real means by which we can debate this order.
	Having said that, I will not take up much more of your Lordships' time. I want to be associated with the Minister's tribute to the DPPs and those who have served on them. I have made that tribute before. They have done a great job. The DPPs, by and large, have worked very well and a large number of their members have had their lives at risk and been threatened but have stood it and stayed with it, so many thanks and congratulations to them.
	A lot of this order, despite what I have just said, was debated at some length when we were passing the 2003 Act, but I would like to ask the Minister one or two questions. The first is on custodial sentencesfive years is not really debatable now. As for all the people let out by Mo Mowlam, that was a long time ago and the five years have long passed. But there is one group of people to consider. I understood that a life sentence is always a life sentence and that life sentences are not commuted and never discharged, even under the two Irish agreementsthe St Andrews and the Belfast agreements. I would like the Minister to tell me that those who have been convicted of life sentences would not be eligible to serve on DPPs.
	Secondly, and on a different line, I am concerned to some extent about the subgroups in Belfast. We were going to have four districts in Belfast and four subgroups. I am slightly confused, because the latest I heard was that there were only going to be two districts in Belfast and I assume that they are only going to have two subgroups. I wonder whether, if we are only having two districts, two subgroups is the right number. Maybe we do not need any subgroups; maybe we should still have four subgroups, working to enlarge the districts. I would be interested to hear what the Minister has to say on that.
	I read a lot of the briefings on this order a week or so ago, and by and large we have no problem going along with it. We believe that policing is progressing. We are thankful for the way it is going. We keep our fingers crossed every day that nothing awful will happen. But the DPPs of all typesboth political and independentare a very valuable part of it and we support the order.

Baroness Harris of Richmond: My Lords, I, too, thank the Minister for introducing the order, and I place on record my thanks to the officials of the Northern Ireland Office who briefed me very carefully on the previous order. I was not able to have a briefing on this order, but I much appreciated that very full and excellent briefing.
	We did not raise any concerns in relation to Sections 15, 16 and 19 of the 2003 Act when it was passing through Parliament, or indeed to Schedule 9 to the 2006 Act. We supported the provisions when they were introduced in 2003 and 2006 but I would just like to say a word about the district policing partnerships and echo the remarks of the Minister and the noble Lord, Lord Glentoran, on the membership of those partnerships, which are now a reality all over Northern Ireland. I, too, pay tribute to the extraordinary bravery and fortitude that members of those partnerships have shown throughout very difficult, stressful and often dangerous times. They are to be warmly congratulated and the success of the partnerships can now be seen all over Northern Ireland. I, too, support and commend this order.

Lord Rooker: My Lords, I am most grateful to the noble Lord, Lord Glentoran, and the noble Baroness, Lady Harris, especially for the tributes to the members. It is the same for those in elected positions in Northern Ireland who have tried to keep normal life going in the last 30 years. For colleagues on the mainland, there is no comparison with what these people have put up with in terms of trying to maintain a semblance of a democratic, civic societyan injured one, it is true, but less fractured now than it has been for many a time.
	The noble Lord, Lord Glentoran, chided me because we had made legislative commitments. I was grateful to be reminded that this is not the legislation for that change; it is purely a commencement order. The debates on the issues took place long before I had any responsibility for Northern Ireland. I apologise to the extent that we have gone over the time for the dinner break. I say purely a commencement order but without it we cannot proceed.
	There is an issue involving Belfast. I understand that the district policing partnerships must mirror the local government and policing operational boundaries. It is up to the Chief Constable to decide how he organises policing in Northern Ireland; it is not up to Ministers. I understand that he has decided to have two DPPs in Belfast. The order allows for up to four. I assume that that will mirror the policing arrangements but that is an operational matter for the Chief Constable and I think that that will be discussed. All we have done is produce enabling legislation to fit the situation.
	The other issue is much more sensitive. The condition is that a person must be out of prison for more than five years. Those with a life sentence can be out on licence. However, if they were out of prison for five years they would be covered in exactly the same way as political members. What has more or less been brought in for independent members is that which applies to the political membersthe declaration against terrorism, which has to be made by councillors; it is also taken by members of district policing partnerships, who use wording that is virtually the sameit was taken from the same legislation. Ministers also have to make a statement. Only MLAs do not have to make such a statement. The point is being out of prison for more than five years, irrespective of the offence or length of sentence. That covers the circumstances that the noble Lord, Lord Glentoran, asked me about.

On Question, Motion agreed to.

Local Government and Public Involvement in Health Bill

House again in Committee.
	Clause 223 [Arrangements under section 222(1)]:
	[Amendment No. 238LF not moved.]

Earl Howe: moved Amendment No. 238M:
	Clause 223, page 155, line 24, at end insert nor a provider of local care services

Earl Howe: The purpose of this amendment is very simple. It would obviate the difficulty of having, as a host organisation, a person or body directly concerned with providing local care services. Why should that situation pose a difficulty? The difficulty, of course, is that it would present a financial conflict of interest. One activity performed by a LINk will be to contribute to commissioning decisions about local care services. Another activity will be to scrutinise those services. If a host is an entity that is being scrutinised, if it is a provider of services that the LINk wishes to criticise publicly or if it is an organisation that is competing to provide care services that the LINk is assessing, it would be impossible for that entity to provide impartial support to the LINk. The conflict of interest at the very least puts the host in a difficult position. The host might, for example, wish to influence a commissioning decision in its own favour, or provide critical reports on a rival service provider, but would be constrained from doing so by virtue of its role as a host. Similarly, the host, as the secretariat for a LINk, could find itself accidentally in possession of information that might be commercially sensitive and directly useful to it; for example, information relating to a rival service provider. It surely cannot be appropriate for that situation to arise.
	The Minister may well talk to us about Chinese walls being created within a host organisation. I want to hear more about what these walls would look like before being reassured that there might be ways around the problems I have just outlined. I am concerned that unless the issue is addressed we are storing up problems for both LINks and host organisations, which would be unfair for them. This amendment provides a simple way forward.
	In this group I shall also speak to Amendments Nos. 238VA, 238VCA and 238ZZAA. Clauses 224 and 225 cover the duties of service providers to respond to and allow entry to local involvement networks. When we look at who falls within the definition of service provider, the list is surprisingly short. Why is that? Why does it not include, for example, independent treatment centres where NHS patients are treated? Why should it not include a private care home where individuals are being looked after at the expense of a local authority? There is a provision in each of the clauses to make regulations. Can the Minister say whether regulations will bring such service providers within the scope of these statutory duties?
	Naturally, this is a probing amendment. I fully appreciate that care homes present particular sensitivities. I am not suggesting that all parts of a care home should be open to members of a LINk to enter as a right. The privacy of residents must be respected. I would be glad if the Minister could tell us what exactly the intention is as regards care homes in the context of the duties contained in these two clauses. In particular, what would be the role and remit of a LINk outside the boundaries of its own local authority, when services had been commissioned out-of-area?
	Amendment No. 238VCA contains an unfortunate double misprint. I speak to the amendment only in passing because the noble Baroness, Lady Neuberger, will be covering the matter of commissioning in a substantive way. For the benefit of the Committee, the word proscribed should be prescribed and the phrase by regulations should read in regulations. The amendment, if taken with Amendment No. 238SB, is otherwise self-explanatory. I beg to move.

Baroness Neuberger: I support everything that the noble Earl, Lord Howe, has said. I shall add a few words on Amendment No. 238SB. This deals with the matter of commissioners, to which the noble Earl referred. The reason for this amendment is that we are, as the Minister has already said, in a fast-moving scenario in terms of health service structures. This legislation is all about service providers, but commissioners make many of the decisions. Some would say that they make all the decisions. Commissioners are, themselves, changing. We will, after all, see more GP-practice-based commissioning, where GPs are also providers. PCTs commission, but are also providers. Commissioners commission from independent treatment centres and voluntary sector organisations, which often fail to respond. Unless commissioners also have a duty to respond to the LINks' concerns, this system may well be full of holes and somewhat inadequate.
	This is a probing amendment to find out what the Minister thinks will be the case with commissioners. I hope the Minister will be able to reassure us that this was simply some kind of oversight.

Baroness Howe of Idlicote: I shall speak to the two amendments in my name, which are also probing amendments. In Amendment No. 238Y, after local authority we seek to add the words,
	a person or body providing services to or on behalf of the National Health Service or of a local authority.
	It is an attempt to gain a clearer vision of who is involved. In Amendment No. 238Z, we seek to leave out paragraph (e), which seems to give rather too much leeway to the Secretary of State by covering everything. If the Secretary of State fails to name all the service providers, he has a fall-back position. That seems a little over-heavy and I question whether it is really necessary. If it is, it tends to indicate that the issue may not have been thought through quite as fully as it should have been. I have also added my name to many of the other amendments in this group.

Baroness Andrews: These amendments raise some important issues and I am pleased to have the chance to discuss them. We have talked about the importance of the role of the host. It establishes the independence of a LINk and is vital in providing support, advice and experience according to local circumstances. I can see that there is a tension, but we think that it can be resolved and I hope to explain how. We certainly want organisations that are critically well versed in matters relating to health and social care to have the opportunity to bid for the job as a host. That is only common sense.
	I understand noble Lords' anxieties about conflicts of interest. However, it will be commonplace for the organisations that are most likely to want to pitch for this work to be in the field. For example, Age Concern may provide bathing services under a contract with a local authority and, at the same time, it may have a contract to provide host support to a LINk. Age Concern currently provides support to PPI forums without its interests causing difficulties. We know that the current providers of support to PPI forumsthe not-for-profit support organisations which have tremendous knowledge and experiencewould be interested in acting as hosts. They have certainly been very interested in the story so far. However, so important do we consider this issue to be that the model contract deals with it explicitly. Indeed, the model tender requirements set out that the host will need to demonstrate that it can identify and manage any conflict of interest in delivering the contract, stating any interest that it has, and a protocol is in place to address those interests.
	Amendment No. 238M seeks to include providers of local care services under the list of organisations that should not be eligible. I hope that I have explained not only why we think that they should be eligible but why they would be well placed to provide the service. Crucially, the local authority will have to take an objective and robust view as to which organisation is best able to deliver the support. We know that some organisations will wish to provide support to LINks and they may also be involved in the delivery of health and care services. We believe not that they are unsuitable but that they may be very suitable indeed. However, local authorities will have to be transparent and clear. When they discuss the relative merits of these bodies, they will have to show that they best fit the criteria. They will performance-manage the delivery. As we discussed earlier, if they fail to satisfy the contract requirements, ultimately the contract can be terminated.
	There are safeguards in the process, not least because the overview and scrutiny committee is well placed to review the hosting arrangements, and the LINk will form part of the performance-management of the host. I believe that the safeguards that are built in are pretty robust. We have advice available to ensure that all organisations have a structure in place to guarantee openness and transparency. Agencies such as the NHS Centre for Involvement, the Centre for Public Scrutiny and the National Council for Voluntary Organisations can all be involved in helping to determine what will go into making an independent organisation with knowledge, sensitivity and understanding of the issues.
	Amendment No. 238V and the amendments in the name of the noble Baroness, Lady Howe, Amendments Nos. 238Y and 238Z, all address the need to expand the scope and reach of LINks to ensure that all who should be monitored by a LINk can be. They seek to change the definition of services-provider to include any provider of a publicly funded service. Noble Lords asked where an organisation such as a private care home fits in? These amendments would mean that independent third sector providers would be named in the Bill as bodies that have to both respond to LINks reports and recommendations and allow LINks representatives to enter and view. That is important, because LINks powers ought to be able to cut across the whole field, but while we agree with the principle we feel that is important to provide for it in ways that are sensitive to differences in the nature of organisations.
	We are clear that independent providers should provide access and information just as public sector bodies do, but it is not our intention to place such legislative duties on the independent sector. That is not appropriate. However, we will ensure that independent providers in either health or social care comply with LINks powers by ensuring that the commissioners of services include that requirement in their contracts through directions made by the Secretary of State for Health. So, there will be accountability and responsibility in line with wider government policy not to place further statutory burdens on the independent sectoras was also the case with the current patients' forums.
	I turn to Amendments Nos. 238VA and 238ZZAA, which also seek to change the definition of services-provider to include the independent sector and all services commissioned within the local authority's area, even if they are provided outside the area. I can reassure the Committee that the amendments are not necessary as the activities of a LINk relate to local care services in a local authority's area. Clause 222(5) covers care services provided in the authority's area and those provided, in any place, for people from the area. So, services commissioned within the local authority's area will include those that people received outside the area where they live.
	Finally, I turn to Amendments Nos. 238SB and 238VCA, on which the noble Baroness, Lady Neuberger, particularly spoke. The definition of services-provider is given in Clause 224(2), and it includes both commissioners and providers of health and social care, which should take care of the noble Baroness's anxiety on that point.

Earl Howe: That was a helpful reply from the Minister, for which I am most grateful. Its only disappointing aspect was that she was a little cursory in referring to the protocols that would be set up to avoid the impact of conflicts of interest where they arise. I am sure that we have sufficient time to examine the draft documents that the noble Baroness has circulated; I shall try to give them more justice than I have been able to so far. Yet these are potentially important issues, and we do not want to walk into a situation where they arise frequently. One can imagine that they might, if the host organisation was of a certain kind.
	I was grateful to hear the Minister talk about the contractual obligations to be imposed on independent sector providers, which would indirectly ensure that they were exposed to the light of day as regards the powers of LINks to enter and view those sorts of premises; that clarification was helpful.

Baroness Andrews: I take the point about protocols, and I commit to writing to the noble Earl to see whether, in the time between now and Report, we can find some examples of protocols that might be being designed.

Baroness Howe of Idlicote: I very much want to read what the noble Baroness said but I still have a lingering doubt at the back of my mind about some areas. However admirable, and indeed they are admirable, the various organisations and the national voluntary bodies that she mentions, it could just be that the relationship between the local authority and one of these bodies was just a little too cosy and the relationship could be a little too easy. I ask the Minister to bear that point in mind.

Earl Howe: The noble Baroness, Lady Howe, makes an important point. We will wish to study carefully what the Minister has said. I am grateful to her for her offer as regards the protocols. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.
	[Amendment No. 238N not moved.]

Earl Howe: moved Amendment No. 238P:
	Clause 223, page 155, line 34, at end insert
	(5A) The Secretary of State shall by regulations specify conditions upon which payments under subsection (5) may be made.
	(5B) The conditions in subsection (5A) shall, in particular, relate to
	(a) governance arrangements, and(b) arrangements for dealing with potential conflicts of interest,
	within a local involvement network.

Earl Howe: One of the least satisfactory aspects of the Government's proposals for LINks, as has been said many times, is their vagueness and lack of tangible substance. In relation to the Bill, local involvement networks are rather like ghosts at the feast; they are invisible and barely defined in any material sense. The Government's argument, which I do not in anyway dismiss because I believe it has something genuine going for it, is that Ministers want to leave it up to LINks to decide how best to set themselves up and they do not want to be prescriptive in legislation about matters of this nature.
	In another place there was a fair bit of debate about amendments designed to introduce an element of prescriptiveness on what a LINk should be and how it should be constituted. Apart from the fact that such amendments are most unlikely to commend themselves to the Minister, I was personally not convinced that this approach was the right one. I have therefore not tabled an amendment of quite that sort. Nevertheless, I remain troubled that what we are contemplating doing through the Bill is to allow structures and organisations to be set up with absolutely no means of guaranteeing that they are fit and proper bodies to be in receipt of public money. Indeed, we have no idea at all about the kinds of organisation to which the money will be going. If the legislation leaves it totally open as to what a LINk can be and how it can behave in terms of its internal operations, then I suggest we are not being responsible as legislators for the way in which the public purse is to be dispensed. There really must be a minimum set of conditions laid down before that can happen.
	The Minister may well argue that all this will be dealt with in the arrangements made by host organisations and that clearly no public money will be dispensed by a host until it is satisfied that the body set up to represent patients and the public is fit for purpose. Of course we trust that that will be the case, but is it enough for us to leave it entirely to host organisations to sort all this out? Do we not have a responsibility to say to those host organisations, You can work within your own parameters, but there are two or three things on which you must satisfy yourselves absolutely before parting with any public money, and on which you cannot compromise?
	A LINk has to have some recognised system of governance to receive public money. I am not saying what that system should be. There are several possible options. But there have to be appointed or elected officers and a constitution that makes it clear what the rules of the LINk are. We cannot do without those things. Somebody or some identifiable group of people has to be accountable for what the LINk does in terms of its public activities, as well as how it operates internally. I suggest that the Secretary of State should make regulations which specify simply that without being any more prescriptive or detailed. I also suggest that although it is not the business of the Secretary of State to dictate who should or should not be a member of a LINk, we have to recognise that for any organisation in receipt of public funds, considerations of propriety do matter in the way it operates internally. In particular, for an area such as this, there have to be clear ways of dealing with conflicts of interests. If literally anyone at all can be a member of a LINk it is obvious that conflicts of this kind are going to arise. They need to be dealt with in some way that is satisfactory. In other words, a LINk should not be allowed to let this issue go by default. If it does, it will fail to do those things for which it was set up, which are to represent the views of patients and the public in a fair and unbiased manner.
	I need take only one example to illustrate the importance of what I am talking about. Under the Bill it is perfectly possible for a provider of local care services to be a member of a LINk. If an organisation such as BUPA, for example, whose staff are people under the Bill, were to be a member of a LINk at a time when it was bidding to provide health services or had already secured a contract to do so, there would need to be procedures to recognise and deal with that conflict of interest in order that the LINk's activities in relation to the bid or the contact were fair and seen to be fair. There is no single way of achieving this, although one excellent way has been suggested to me, about which I can tell the Minister later if she is interested. The point here is that conflicts of interest, whatever form they take, will inhibit arms-length, unbiased input from LINks. That has to be avoided.
	This amendment is minimalist. It would bind the Secretary of State only in the sense that he would be obliged to make regulations which addressed the issues of governance and conflicts of interest without being prescriptive in either case and which made such minimum stipulations about those matters in relation to LINks as he saw fit. I beg to move.

Lord Rea: I wish to speak briefly to Amendment No. 238Q. It is self-explanatory. Its purpose is to provide independence of the host organisation and, through it, LINks from the local authority. In other words, to use my noble friend's own words, to stop them being a creature of the local authority: he who pays the piper must not call the tune. We want this to be in the Bill so that if this direction is not obeyed the local authority will be committing an offence and can be called to account for it. I do not need to say much more. The noble Baroness knows exactly what she is going to say and we look forward to hearing it.

Baroness Neuberger: I follow on with a brief word on Amendment No. 238S. Following what the noble Earl, Lord Howe, and the noble Lord, Lord Rea, have already said, there are concerns around the Chamber about conflicts of interest and how these relationships are going to work. We have tabled an amendment which suggests that a link could have the power to direct the actions of the host in pursuance of some of the arrangements. The reason for this relates to what the Minister said earlier on, which is that the host is a servant of the LINk. How does the LINk have power over an unco-operative host? The unco-operative host may have a conflict of interest because it is already a provider of services. Does the LINk have the capacity to fire the host? This point was made very powerfully to me by Robin Tuck, the chairman of Kensington and Chelsea patients' forum. His view is very clear. He says that in the proper discharge of its duties, for instance, a LINk needs to commission research about what is happening on its patch. It will have to do that if it is going to make sense of what is going on. How can it do that if it does not hold the budget? The host holds the budget, but what if the host does not agree with the LINk about the need for such research, at least in part because the host is a provider of services and does not want them looked at too closely? Surely the LINk must have the power to compel the host to fund research or whatever else is required. In other words, it must be the LINk that has the power in this relationship rather than the host if the LINk is to be effective. It would be good to be given some clarification on this issue.

Baroness Andrews: My noble friend is quite wrong because sometimes I do not know what I am going to say. I am departing from my note here and I hope that my officials do not fall out of the Box in horror. I shall try to follow it as much as is appropriate. These are important amendments, but I think that reluctantly the noble Earl and I shall have to disagree about them. He is wrestling powerfully with the notion of a wraithlike creature here, but I know that as we go through the amendments, things will become clearer. I can see the thinking behind the noble Earl's amendment in the context of governance and conflicts of interest, but the problem lies in the notion of imposing a structure on the LINk. No matter how tempting it is to lay down a set of critical elements of what should be in place, we remain sure that it is not appropriate in the context of what we are trying to create. It should not be for the Government or Parliament to take the responsibilities away in this area, or for any body other than a LINk to determine its governance arrangements.
	The noble Earl said that everyone would have to have some form of constitutional or elected office. There may be models which are co-operatives or where there is a slightly more fluid arrangement. The problem is that once we start prescribing governance models, we will get into the sort of detail from which it would be difficult to move. It would resemble the problems we had with the patients' forums when their functions were set out in the detail of the legislation. Every LINk will need to address different factors depending on geography, demography and local healthcare arrangements. Given that, I am afraid that regulations could hinder these processes rather than help them.
	I know that this response will be disappointing to the noble Earl, so I should make it clear that I accept that the LINks will need support and guidance to enable them to come to decisions about issues such as governance and conflicts of interest. It is certainly our intention to make those resources available and to help them all we can. The nature of the negotiations that will go into settling the contract to agree the governance arrangements for LINks will have to ensure that no one single organisation can dominate. That will be part of the challenge of management, and it will be a challenge because the membership of the LINks will be wide-ranging. On the other hand, there is a strength in that. LINks will be able to accommodate special interests more readily than a patients' forum, which had a much more limited membership. Further, it is true of any statutory institution that it has to be able to manage potential conflicts of interest by ensuring that interests are recorded in accordance with standards in public life as made clear in the Nolan principles. We will provide examples of best practice to support the LINks in that context.
	I know that my noble friend anticipated my response, and it is true that Amendment No. 238Q is not required. The local authority has no power to influence the activities of a host or a LINk other than through the terms of the contract. We will set out in guidance what is an appropriate role for the local authority and host, but the guidance will certainly not dictate governance arrangements, terms of reference, ways of working, priorities or programmes. The notion of independence will be very substantial and not at all wraithlike. It will be clear that the local authority cannot influence the arrangements, and the host organisation will be accountable to the local authority in terms of performance management as its contract manager for the support costs. The LINk will be accountable to the public to demonstrate the effective spend of its budget, for example.
	On Amendment No. 238S, I note with interest the desire of the noble Baroness, Lady Neuberger, to put into the statute that:
	A local involvement network shall have the power to direct the actions of H in pursuance of the arrangements under section 222(1).
	The first point to make clear is that the arrangements are of a contractual nature and will be made between the local authority and the host. Our expectation is that there will be dual accountability. It is interesting to consider the medical analogy here. The host can reject a parasite, and there is something of a duality here. On the one hand the host will be accountable to the local authority in terms of the delivery of the contract arrangements, while on the other hand it will be accountable to the LINk for delivering support. We are setting out our expectations in this respect in the model contract and supporting guidance.
	The noble Baroness has raised some interesting issues and I should like to think further about them. I am not saying that I will come back and subscribe to the scenario, but over the summer we will have an opportunity to consider some of the tensions and possibilities. With that, I hope she will not move her amendment.

Earl Howe: That was a slightly disappointing reply although it was not wholly unexpected. The principal point I was trying to make is that each LINk has to have some form of governance if it is to have a voice that can be ascribed to it; otherwise what is to distinguish a LINk from simply an informal and disparate group of people who happen to be in communication with each other? Even co-operatives have to have some form of governance. We cannot have a body with no governance at all; we cannot have an organisation with no formalities associated with it. This is the point I was driving at. We cannot channel public money into an area that literally has no basis for being an entity of any kind. I am troubled that we are trying to be so flexible with the Bill that we may end up being less scrupulous than we should be on the use of public funds.

Baroness Andrews: Perhaps I can reassure the noble Earl. I quite agree with him; I cannot conceive of an organisation that does not have a governance structure or responsible people identified with whom to form a relationship for the delivery of the contract. The only question on which we disagree is whether we should try through regulations and the role of the Secretary of State to formulate anything like that on the face of the Bill. That is what divides us.
	I am also interested in the possibility of being told later how it will all workthe contracts, the conflicts of interest via BUPA, the question the noble Earl raised and the offer he made.

Earl Howe: I shall certainly be glad to follow that up. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.
	[Amendments Nos. 238Q to 238QA not moved.]

Baroness Neuberger: moved Amendment No. 238R:
	Clause 223, page 155, line 36, at end insert
	( ) Nothing in the arrangements shall prevent a local involvement network from
	(a) making collaborative arrangements with another local involvement network; or(b) utilising monies received from H for such a purpose.

Baroness Neuberger: Again, this is a probing amendment. Almost all the amendments today have been probing amendments. It seeks to test out whether some LINks can make collaborative arrangements with other LINks; whether they can use the money that they get from the hosts for this purpose in order, perhaps, to form themselves into a representative body, either regional or national; and whether the hosts can stop them doing thatin other words, whether there are no limits on what they may do.
	If they are going to do that, there will need to be some basic principles. The Involvement Network suggests that these should apply to LINks, hosts, local authorities and NHS health and social care commissioners and providers, and that the principles should include being committed to working positively with other LINks and other bodies of whatever nature involved in commissioning, supporting or otherwise improving the health and well-being of local communities and communities of interest. It suggests that that will need some kind of national network.
	Ministers have suggested that the proposed National Voices project or the already existing NHS Centre for Involvement could replace some of the functions that the Commission for Patient and Public Involvement in Health now serves or that some kind of joint body of LINks could create. However, it is rather difficult to see how either the new National Voices project or the NHS Centre for Involvement could play the same kind of direct part in protecting the independence of LINks in the same way that LINks banding together could do. One of the reasons for that is that neither is set up or funded to fulfil that function, or was expected to have the same direct connection with LINks as the commission has at the moment with patient forums. National Voices is still some way from being established, while the national centre is a Department of Health contractor and so, you could argue, not appropriate to be a national independent body for LINks.
	If there is to be a system with LINks, there remains a clear need for an independent national body to promote patient involvement as well as promoting some of the broader issues around health and social care on behalf of all the people involved in that world. LINks need to be allowed to work together and to use the money they get from hosts to do so. It may be an extension of the present National Association of Patient Forums or it may be some other model that might suffice, but we need to be clear that there is nothing to stop them doing that or using money from hosts to do it. I beg to move.

Earl Howe: I believe and hope that the Minister will reassure the Committee that there is nothing to prevent LINks from forming collaborative arrangements if they wish to do so. The reason I am worried about this is the wording of Clause 222. When a host organisation makes arrangements to deliver the activities listed in that clause in a local area, it will be obliged to look at what the clause says. It refers to activities that are wholly and exclusively focused on local care services. A national or regional umbrella organisation for LINks would inevitably have a wider purview than the local area of an individual LINk. The benefit of such a body would, as we have heard, enable LINks to share ideas and best practice, provide information, co-ordinate efforts and generally promote good communication between members.
	LINKs are almost certain to want a national voice. For example, there may well be occasions when a national survey on some particular aspect of healthcare is called for. To the extent that an individual LINk contributes to that activity by means of a financial subscription, it will not be directing its budget to those activities prescribed for it in Clause 222. How should a host organisation view that eventuality, if it were to happen? The Minister may give perfectly sincere assurances on this, but against a literal interpretation of the clause, the host organisation might well find itself in some difficulty. There should be an explicit mandate in the Bill to create a national representative bodynot necessarily in terms of this precise amendment, but something along those linesbecause otherwise my fear is that someone will come along and accuse local involvement networks, and possibly also their hosts, of acting ultra vires. We ought to put the matter beyond doubt.

Baroness Howe of Idlicote: I hope the noble Earl, Lord Howe, will be proved wrong, and that the Minister will be able to reassure us. This is an important idea. There has been a lot of criticism recently that the thirdthat is, voluntarysector has become almost too much part of state activity, and therefore its ability to be creative and think ahead of time about what will need attention will be stifled. It is indeed the voluntary sector that gets busy in those areas first. I see here a possibility, with co-operation and some basic funding, for new ideas and for harnessing the LINks in a way that is of national importance and picks out some of the issues that will be of crucial importance for the future. I hope the Minister will be able to assure us of that.

Baroness Andrews: This is an interesting and sympathetic proposal. We have always made it clear that LINks can work together on issues that they think go beyond their boundaries. We certainly would not wish the legislation to get in the way of that type of activity. For that reason, the key here is to ensure that legislation does not inadvertently restrict the possibilities. I believe that if they were to come together, regionally or nationally, it would help them to share intelligence about what works.
	The noble Earl has drawn my attention to the wording of the clause, but I was anyway going to propose that we take the Bill away and look at it. The last thing we want is for the Bill to create barriers, so I am grateful to him for identifying that issue.
	The noble Baroness, Lady Neuberger, asked whether there was anything to stop the LINks using their funding either to form regional associations or join a national association. We probably would not want to mandate them to join a national association but there is nothing to stop them using their resources, if they so wish, to come together and form one, although some may not wish to and others may wish to be part of a loose confederation. However, we would welcome this happening and for those reasons I support the noble Baroness's amendment.

Baroness Neuberger: I thank the Minister for her response. I am grateful to the noble Earl, Lord Howe, for pointing out the difficulty, which I had not spotted. It needs to be sorted out, so I am extremely grateful to the Minister for saying that she will take the Bill away and look at it. Given the assurances that there is nothing to stop the LINks getting together and using the money they get from the hosts to pay subscriptions, or whatever, I am enormously grateful and reassured. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.
	[Amendment No. 238S not moved.]
	Clause 223 agreed to.
	[Amendment No. 238SA not moved.]
	Clause 224 [Duties of services-providers to respond to local involvement networks]:
	[Amendment No. 238SB not moved.]

Earl Howe: moved Amendment No. 238T:
	Clause 224, page 155, line 42, leave out dealing with and insert responding to

Earl Howe: I shall speak also to Amendments Nos. 238U and 238UA. The heading of Clause 224 is:
	Duties of services-providers to respond to local involvement networks.
	However, when we read on we find that this is not quite what the clause says. In delineating the regulations which the Secretary of State may make, it refers first to services providers responding to requests for information from a LINk. That is fine. But then, in relation to reports or recommendations made by a LINk or by another services provider, the words responding to are replaced by dealing with. What is the significance of that? I can deal with a report or recommendation by ignoring it altogether and putting it in the wastepaper basket. I can deal with it by reading it, disagreeing with it and taking no further action. In other words, I can deal with it without having to account to anyone else about what I have done and why. I am not sure that it is appropriate or in the spirit of the clause to have the words dealing with in this context, which is why I suggest that the words responding to might be better. It will be helpful to hear what the Government have in mind to put in regulations here.
	On Amendment No. 238UA, we come back to the issue of outcomes as opposed to mere processes. Services providers are to have duties conferred on them to respond to requests for information and to deal with reports and recommendations; but nowhere here is there any sense that they are supposed to take action to improve services where there is a clear case for doing so. Not all reports or recommendations from a LINk will be persuasive but when they are, someone ought to be concerned with taking the recommendations forward, otherwise the whole exercise might just as well not have been started. I should be glad if the Minister could reassure me on this point. I beg to move.

Baroness Andrews: At one level, Amendments Nos. 238T and 238U address a detailed semantic issue, the like of which we always enjoy. If we unpick them, noble Lords will see that the change is unnecessary as well as undesirable. However, the noble Earl has done an excellent job in pointing out the difference between dealing with and responding to, but the merit in this case lies in dealing with for almost exactly the reasons that he put forward.
	I know that he thinks that dealing with has a negative connotation, suggesting that a service provider would not have to provide LINks with a proper response. However, that is not the case, because dealing with covers everything that could be put in regulations on responding to a report. It allows also for regulations to state what a services provider should do if it received a report or recommendation, but was not the body that was required to respond to it.
	Commissioners of services should respond to reports and recommendations as they are ultimately responsible for the services that are provided within an area. They are certainly best placed to deal with a strategic report. If the report were to be sent to the provider, the regulations could place a duty on that service provider to forward it to the relevant body that commissioned the services.
	The use of the phrase dealing with is deliberate, because it gives a wider power than responding to. It allows for services providers to pass reports to the relevant body with a duty to respond. It therefore gives more purchase on the system than does merely responding to. I hope that the noble Earl will accept that.
	I turn to Amendment No. 238UA and the proposal to take a power to allow regulations to impose a duty on a body receiving recommendations from a LINk to demonstrate that, where relevant, it has acted to improve services in response. I completely agree that a PCT or local authority receiving a report from a LINk should be required to take some action and certainly should respond to the LINk. We intend that a local authority or PCT be obliged to acknowledge receipt of a report or recommendation, and supply an explanation of the action that it intends to take or why it does not intend to take any action.
	Those bodies receiving reports and recommendations will need to take account of many factors when considering a LINk's ideasmany of them may not be known to the LINk. Not every LINk recommendation if followed would necessarily lead to improvements in services, and the bodies responsible for the services would need to take a view on whether the advice was followed.
	I hope that the noble Earl, bearing in mind that slight complication within the actions, will feel able to withdraw his amendment.

Earl Howe: Perhaps I may deal with with the Minister's helpful reply by thanking her for it. I am in part reassured by what she said, because if that is the Government's intention as regards framing the regulations, we can rest assured that the appropriate actions will be laid down. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.
	[Amendments Nos. 238U to 238VCA not moved.]
	Clause 224 agreed to.
	Clause 225 [Duties of services-providers to allow entry by local involvement networks]:

Earl Howe: moved Amendment No. 238VD:
	Clause 225, page 156, line 22, leave out view and insert inspect

Earl Howe: I shall speak also to Amendments Nos. 238VE and 238W. Clause 225 deals with the duties placed on services providers to allow authorised representatives of local involvement networks to enter and view their premises and to observe the activities taking place within those premises. I think that we need to understand a little more closely from the Minister what this duty will amount to in practice.
	First, on the word view, those who used to be members of community health councils and those who are currently members of patient forums will tell you that one of the essential features of their functions and powers was the right not only to enter premises but to carry out detailed inspections, part of which could well involve talking to service users and staff. The ability to talk to users and staff is absolutely vital, because without that it is well nigh impossible to gauge the quality of the service being provided. When negligent care is discovered by PPI forums, it is usually as a consequence of disclosure by a patient or a member of staff to a forum member.
	If I have a concern about the word view, it is that it suggests something rather more remote and passive than the word inspect. If an estate agent takes me to view a house, I expect to be able to look round it without necessarily being allowed to spend time there investigating the state of the plumbing. A viewing, in ordinary language, is not the same thing as an inspection. Patient forums have the right to enter and inspect, as did CHCs before them. Why is not the word inspect used here as well, and what significance should we attach to that?
	Secondly, I return to what LINks will be there to do. When they decide to enter and view premises, they will not be there simply to observe the activities going on within them. The point of entering is to monitor the quality and effectiveness of the services being provided. I believe that there is a strong case for having that explicitly stated in the Bill. As the Bill stands, the duty on services providers will extend only to allowing authorised representatives to enter, view and observe. Without a purposive context to this, I would worry that certain services providers might take it upon themselves to deny LINks members a full opportunity to gather the kind of information that they need from the visit. The amendment would strengthen the duty by making it clear that it is not sufficient to allow a nominal sort of viewing or observation by LINks members; it is necessary also to facilitate them in carrying out their task.
	I turn finally to Amendment No. 238W, to which the noble Baroness, Lady Howe, will speak more fully. I simply want to say this. I understand that the Government propose to make provision in regulations that visits to premises by authorised representatives may not take place unless the LINk has previously notified the appropriate regulatory body of its intention and the regulator has not objected. I can quite see why we should want to avoid inundating services providers with inspections and visits from myriad inspecting bodies. However, I seriously question whether a blanket limitation of the kind proposed is the right way to go.
	If LINks are to have any credibility at all with the local community, they need to have their own visiting regime, including the ability to make spot visits where there is an urgent concern. The scope for such visits to make a difference to the quality of care is considerable, but if you hedge those visits about with bureaucratic processes and permissions from a remote national body, that potential will be greatly diluted. Indeed, the extent of the restrictions that the Secretary of State can impose through the regulation-making power is so great that I wonder what, if any, freedom of movement will be left to LINks at the end of it all. Patient forum members will tell you that visits to premises are important both to raise public confidence in the NHS and for public safety. The regulations are likely to create a wall between local people and the services that they pay for. I believe that that wall would undermine public confidence in patient and public involvement and in the independence of LINks. I beg to move.

Baroness Masham of Ilton: If noble Lords watched the Panorama programme on care homes earlier this year, they would have seen why this amendment is necessary. If noble Lords did not see that programme, they really should, especially the Minister. What is the point of bodies such as LINks if they have no powers, especially no inspection powers?

Baroness Howe of Idlicote: This group of amendments strikes at the core of our concern. Frankly, one is given the impression that the powers of LINks will be considerably less than the powers of PPI forums and that their ability to be heard will be less, which is perhaps even more important. One should not forget that the Commission for Patient and Public Involvement in Health was a national body that could amplify any concern that a PPI forum might have had in the past. It had considerable power, exercised with considerable responsibility. I believe that there was not a single complaint as a result of the visits, which says quite a lot.
	Amendment No. 238W is about the conditions to be satisfied before a duty arises in a particular place. It is rather insulting and belittling that one will be subjected to those conditions. I understand that it is a matter of security in a private care home that is being inspected. Inspection must be the word that is used if we are to have any confidence in this. The position seems to be: It may be one, two or three people, we are not quite certain and goodness only knows how many people you are going to consult.
	I am particularly impressed with the nursing side. The Royal College of Nursing is not really impressed with some of the suggestions and does not see them as likely to provide the comfort that we are looking for. I shall not say any more because the noble Earl, Lord Howe, has put the matter so well and my noble friend has made a very graphic point about the television programme. I echo her view that, if possible, the Minister should see it. Other noble Lords and I believe that this matter is very much the key to whether this is going to work and whether we can regard the new organisation as an equal, if not better organisation, which looks after the different interests of people, which actually delivers and which is not seen as a fairly amorphous body without any teeth.

Baroness Neuberger: The amendment goes to the heart of this legislation. We are all deeply concerned that LINks will not have powers. It is clear that regulations will be written that are likely to restrict, very considerably, what LINks can do in terms of inspection. We are all extremely worried by that.
	I wish to draw two things to the Minister's attention. One is that there appears to be a desire to limit the hours when LINks members can inspect or visit. That seems quite serious because it more or less prevents any opportunity for spot checks. If you talk to members of patient forums and people who have been involved in any kind of inspection and monitoring of any service, they will tell you that one thing that you need to have is a right, if you like, to make spot checks to see that things have not been prepared so that they look better than they normally are. I would be very grateful if the noble Baroness could clarify that point in her response.
	The other thing is a point that I raised at Second Reading with the noble Lord, Lord Hunt, about the idea that on Healthcare Commission inspections, which can be both spot checks and arranged visits, a LINk person or patient representative should go along as part of that team. The noble Lord, Lord Hunt, said that he would take that away and look at it. As far as I am aware, the Healthcare Commission is not opposed to that idea at all. If we really want to strengthen the role of LINks in monitoring and inspecting our services, that is one way to do so, but they need to have a right to inspect when they want as well.

Baroness Andrews: These are indeed important amendments and I want to reassure noble Lords in different ways. I am grateful to them for raising the issue, because it merits clarity and debate.
	Obviously, the issues that Amendment No. 238VD raises came up quite a lot at Second Reading. It is important to state here, as was stated then, that in practical terms view and inspect mean much the same thing and that the use of view does not in any way diminish the power that LINks have to enter services. I hear what the noble Lord says about view sounding rather passive, but the term was chosen specifically to recognise that LINk participants are not inspectors or regulators. The term inspect relates to professional regulatory bodies such as the Healthcare Commission. Those involved in LINks are lay people and, as such, are able to take the patient and user perspective. There is not any diminishment of power from the patient forums and I suggest that noble Lords reconsider their arguments because of that. However, I am keen to be helpful and, because noble Lords are clearly of a mind that this is an important matter, I will take it away and think it through.
	Amendments Nos. 238VE and 238XA both seek to ensure that LINks can monitor services when they visit them. Again, I understand the purpose of these amendments; we have already considered it. That is why Clause 225(4)(a) states that any visit by a LINk must be,
	carried out for the purposes of carrying-on,
	LINks activities. Clause 222(2) lists one of the LINks' activities as,
	enabling people to monitor, and review, the commissioning and provision of local care services.
	I hope that that meets the point raised by the noble Lord and that he will not press his amendment, because it is captured in the Bill.
	I turn to Amendments Nos. 238W and 238X. We think that the power to interview and observe is very important for LINks to be effective. The power of LINks extends beyond that of patient forums to cover social care as well as health. We also believe that it is important to take account of some key issues when providing for LINk members to enter and view services to protect service users' safety and dignity, as well as to safeguard the smooth operation of services. Clause 285 therefore sets out some areas where detail is required when the Secretary of State makes regulations in respect of those powers. Amendments Nos. 238W and 238X seek to remove the power to make these conditions and safeguards.
	I accept that it appears that we are giving LINks power with one hand and taking it away with the other, so it is very important to be clear. The power to enter premises is a formidable one and rarely given; giving it to members of the public is extremely significant. I am sure that noble Lords agree that we cannot be lax enough simply to allow the power to be used without safeguards. We have to bear in mind the fact that it is not just the power to enter premises; it is the power to enter premises where ill, vulnerable and distraught people are receiving treatment.
	Subsection (2)(a) allows for conditions to be satisfied before the duty arises. This will enable the Secretary of State to make regulations that state, for example, that a LINk must inform the regulator before undertaking a visit to a services provider. I understand what noble Lords have said and I take the point made by the noble Baroness, Lady Masham. This is part of a cross-government gatekeeper initiative that, with the best of intentions, aims to reduce the burden on front-line service providers and to prevent duplication, endless visits and people having to stop looking after people, which is much more important, in order to take someone around, facilitate discussions and so on. We think that it is particularly appropriate in the case of LINks that their visits should be co-ordinated with the work of the regulator to ensure that there is no duplication of effort.
	These details would be set out in regulations and specify areas where we do not expect people to enter and view, such as in children's premises, and so on. We intend to publish draft regulations and conduct a full consultation on them before we lay them in Parliament.
	Amendment No. 238X seeks to remove subsection (3), which would allow for limitations on the right to enter and view premises. For example, we would intend that a LINk should visit only when appropriatethat is, when services are being provided. Equally, it is important to retain the ability to provide some detail on the number of LINk members visiting premisesfor example, it could become clear that it would be appropriate to have a minimum of two LINk members on each visit. I take the point made by the noble Baroness, Lady Neuberger, at Second Reading. I will follow that up, because it has interesting potential.
	I believe that the powers set out in Clause 225 represent important parameters on the duty, but I am conscious that noble Lords have spoken with one voice on the importance of unannounced visits. I am not making any promises, because this is part of a cross-government attempt to rationalise the way in which inspections are made, but I will take this matter away and talk to officials and Ministers about this and come back on Report to make our recommendations.
	I should say that all those involved in this part of the LINks role will have to have the right skills, receive the right training, be cleared by the CRB and be able to demonstrate understanding of patient confidentiality. It is a serious undertaking and we are putting serious measures in place to ensure that it is done properly.

Baroness Masham of Ilton: Perhaps I may intervene before the noble Earl winds up. I cannot see that visitors will endlessly pour into care homes with vulnerable patients who are sometimes never visited. It is a different matter when patients are visited by family and friends, but many people are put in suspect homes and are vulnerable. It is surely our duty to ensure that someone goes in to check the food and to see whether patients are being hit. That is protecting people. These LINk people will have so much to do that they will not have much time.

Baroness Andrews: One thing that I did not make clear was that LINks will be able to enter and view only communal areas of residential care homes and residential nursing homes. However, I take the noble Baroness's pointthere may not be lots of LINks visits, but people go into care homes for many different reasons, not least CSCI inspectors, who make unannounced visits. It is a question of getting a balance between being able to offer the sort of insight and potential protection for vulnerable people and not overburdening hard-working and dedicated staff and taking them away from their front-line responsibilities.

Earl Howe: I am sure that we all understand that conditions have to be attached to these visits; there is no argument about that. The question is how narrow or wide the conditions should be. I am grateful to the Minister for saying that she will look again at the issues underlying the amendments in this group. There is considerable unanimity among noble Lords from all sides of the Committee on these matters. I do not wish to delay the Committee, so I hope that we can progress these discussions during the Recess. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.
	[Amendments Nos. 238VE to 238ZZAA not moved.]
	On Question, Whether Clause 225 shall stand part of the Bill?

Baroness Meacher: I will introduce a very different note. I should first declare an interest. I am the chairman of a mental health trust in east London and my organisation would fall within the remit of a local involvement network. Nevertheless, I hope that my brief remarks will be constructive and will support the Minister in her deliberations about Part 14.
	In declaring my interest in this matter, I make very clear my strong commitment to service-user involvement in service provision. In mental health we have been working long and hard to involve our service users in a meaningful and fulfilling way. Indeed when I became chairman of the trust, one of my first actions was to create a service-user sub-committee of the trust board at the very highest level of the organisation. In that committee the various representatives of our many service-user forums across the trust come together with board directors to discuss policy and any issues of concern to those service-user representatives.
	In questioning the inclusion of LINks in this legislation for health services, I emphasise that I am an advocate of user and public involvement. However, I believe that Part 14 requires some more work before it is set is stone. The creation of LINks to ensure public involvement in the monitoring of social care facilitiesthe social care homes and nursing homes to which the noble Baroness, Lady Masham, referredwhere such visits are lacking, may prove a helpful way forward. My concerns in relation to this are limited to the health services, and in particular the mental health services.
	Clause 225 places on the service providers a duty to allow entry by local involvement networks to,
	view and observe the carrying-on of activities on premises owned or controlled by the services-provider,
	as mentioned by the noble Earl, Lord Howe. If LINks are to be established and have a right of entry to view the staff and patients on wards, I would strongly support the Government's provision that some restrictions will need to be placed upon that right. However, I have an apparently controversial view within this House that there should not be another body whose members will visit hospital wards at this time before further detailed work is done; I strongly emphasise that work. By it, as I will say later on in relation to other clauses, what I mean is that these LINks should be piloted and evaluated, and we should be absolutely sure that they are effective and efficient and work to the benefit of patients and service users before we find these things being brought into play.
	Why do I take this view? We know that there are already inordinate numbers of bodies charged with visits to hospitals and hospital wards for one reason or another. The number 56 has been referred to in relation to the total number of bodies that come into health services for inspections and monitoring. I just want to mention five. The Mental Health Act Commission undertakes announced and unannounced visits to wards to inspect the operation of the Mental Health Act 1983. It checks on care and treatment of detained patients.
	When the commission has merged with the Healthcare Commission, I understand that its ward visits and interviews with patients will continue. The Healthcare Commission visits hospital wards, as other noble Lords have mentioned. Again, those visits can be announced or unannounced. Mental Health Act managers regularly visit wards. They are members of the public rather than NHS professionals. Apart from undertaking appeals at the request of patients, those managers are concerned about the standard and quality of care of patients and the individual patient's experience of that care.
	Mental health review tribunal members have a right to see patients on the ward. The new boards of governors of foundation trusts also need to have access to wards and other facilities that are managed by the trust. Those bodies, like LINks, represent patients, service users, carers and the public. That is the nub of what I feel so strongly about. I will say more about these boards in relation to other clauses.
	The noble Baroness, Lady Neuberger, suggestedhelpfully, I thinkthat a LINk member might joint a Healthcare Commission visit. However, the boards of governors will want to join those visits. There really is a duplication here in relation to the health sector but not, I fully accept, in relation to social services. Both sets of peopleservice users, carers and the publicwill go around assuming that they are the key body that represents users, carers and the public; they will monitor services, feed back to providers, want their views to be taken seriously and so on. How will all that work?
	Unlike care homes, hospital wards are overwhelmed by visits from inspectors and monitoring bodies and governors add the all-important voice of service users and carers. If LINks also visit wards, they will risk duplicating precisely what governing bodies will be doing. The wards really cannot cope with that sort of duplication.
	Leaving inspection on one side, wards are under the most incredible pressures these daysgreater pressures than they have ever experiencedbecause the in-patient population is ever more challenging: more and more patients are managed within the community even when they have very severe psychotic symptoms. Only the most ill and high-risk people ever get into a hospital ward these days.
	The value added of every inspectionevery monitoring visitshould be carefully assessed to ensure that the benefit to patients and service users really does outweigh the distraction of staff from the job in hand and disruption to those very disturbed patients.
	I hope that the Minister will agree to commission work to analyse the many demands on hospital wards and how best to avoid duplication by LINks and boards of governors of foundation trusts in particular before pressing ahead with Clause 225.

Baroness Andrews: I am grateful for that contribution, not least because the noble Baroness is so experienced; I pay tribute to her for her work in the mental health field. I will not repeat my speaking notes on the clause.
	I am very aware, from our previous debate, that the sort of issue that the noble Baroness raised is precisely the sort of reason why we have been advocating the gatekeeper function. We must be very careful about what could happen. There are clearly tensions in this situation. She is absolutely right that there should be a guarantee that if this sort of opportunity is offered, it must be of benefit to the institution as well as being right for the LINk. I take that point entirely. We can also learn from experience. These powers were those of the patients' forums. It is important for us and all potential LINk organisations to be able to look at this.

Baroness Meacher: Our own PPI chairman has decided that PPI is not the place to be. She has become a member of a board of governors and plans to pursue her PPI functions through it. That is interesting because people here have talked about LINks replacing PPI. In my experience on the ground, boards of governors are replacing PPI. That is, perhaps, something to think about.

Baroness Andrews: That is part of the evolutionary nature of the boards of governors. The relationship between boards of governors and LINks must converge rather than duplicate. We want to see foundation trusts joining LINks and contributing to their research, and vice versa. There must be synergy here; that is common sense. This is something we want the local authorities to urge the host to do. Maybe you could put it in a contract. One of the protocols would be that you were not duplicating the work of people who had other relationships with the sector. That is absolutely right.
	With regard to the mental health function in particular, since LINks are bringing together social care and health, we will have for the first time a convergence of interests, although I would not say that it will be seamless. It is likely that more consumer interests will overlap in relation to mental health than in other parts of the health and social care services. It is possible that giving LINks powers to enter and view, particularly when it comes to mental health, will bring a slightly different dimension to it. I do not know; I will leave that for the noble Baroness to think about.
	The noble Baroness has made a very powerful contribution. As I said, we do not intend that anyone undertake this role without the right skills and training, or if they cannot learn from the best experience. We have not finalised all the details. We will be looking at this in relation to regulations on which we will consult. There is certainly time to tease out some of these implications.

Clause 225 agreed to.
	Clause 226 [Local involvement networks: referrals of social care matters]:
	[Amendment No. 238AA not moved.]
	Clause 226 agreed to.
	Clause 227 [Local involvement networks: annual reports]:

Baroness Neuberger: moved Amendment No. 238AB:
	Clause 227, page 158, line 41, leave out person preparing it and insert members of the local involvement network

Baroness Neuberger: This is another probing amendment. As regards the LINk's annual report, we have replaced the Bill's reference to the phrase person preparing it, and replaced it with members of the local involvement network. We would argue that the LINk, corporately, has the duty to prepare an annual report. We would like to hear what the Minister has to say about this. We are probing whether the Government would be content for a person such as a parent to take such responsibility. Surely the LINk should take responsibility. If the LINk is to mean anything, its members must have views about all this, and so should have a duty to prepare and produce an annual report. Essentially it belongs to them. I very much hope that the Minister can reassure me on this matter. I beg to move.

Baroness Masham of Ilton: Who is going to receive the report?

Baroness Andrews: That is a devastating question; I will think about it while I am answering the first question. I am not entirely certain that I will give the noble Baroness much satisfaction on this. It comes back to the rather circular argument about the LINks not being on the face of the Bill. Amendments Nos. 238AB and 239ZA seek to make it a requirement that once the annual report has been drafted it should be distributed in such a manner as members of the local involvement network, having had regard to any guidance issued by the Secretary of State, consider appropriate. As the clause is currently drafted, the person preparing the report should have regard to the guidance, and the noble Baroness has asked us to change that.
	There are problems with mentioning the members of LINks in the Bill because, as we said, the notion of membership may be conditional. We do not wish to pre-empt LINks in organising their governance structure and ways of workingas I said, some may want a notion of membership and others may not. However, there is a further complexity. Although it is somewhat complexthat is quite an admissionClause 227 has been drafted carefully to ensure that someone is always responsible for writing an annual report for LINks. Usually, the host will assist the LINk in the preparing the annual report. However, the provision is drafted as it is because at times a LINk may not be in placefor example, when the host has recently been set up and the LINk's structure is not yet defined and it has not yet begun to undertake its activities. In that case, the host will still be expected to cover in its annual report the activities that it has undertaken.
	It would not be workable to accept Amendments Nos. 238AB and 239ZA because members of a LINk may not necessarily be available to decide how an annual report should be distributed. Therefore, we think it appropriate that whoever drafts the annual report should have regard to the statutory guidance in deciding how it should be distributed. Perhaps we could think about making some sort of reference to that in the guidance. With regard to who will receive the report, it will certainly be made available to the general publicthat is the whole point of the exerciseand it will also go to the overview and scrutiny committee, the local authority, the PCT, the other partners and the Secretary of State. Therefore, it will have a wide circulation.

Baroness Masham of Ilton: What about Members of Parliament?

Baroness Andrews: Why not Members of Parliament, and Peers?

Baroness Neuberger: When the noble Baroness admitted that the drafting of Clause 227 was somewhat complex, she provided a moment of satisfaction for those of us who have struggled to understand what it means. That was very nice. She also said that she envisaged a situation where a host might prepare the annual report because the LINk did not yet exist. Can the noble Baroness foresee a situation where, for some reason or another, a local authority might appoint a host but a LINk either might not come into existence quickly or might not come into existence at all? How would that work? I had not thought about it until she mentioned it, but it seems to me that it is worth testing whether that is a possibility and, if so, how the structure would then operate.

Baroness Andrews: That is an interesting question. The nature of the contract that the local authority would hold with the host would require the host to facilitate and enable the LINk. Therefore, if the host were so hopeless that it never got it together, I would say that the LINk should start again with another host.
	With regard to the timing, I would hope that a host would not be in the position of writing an annual report a year after it had set up. Again, that would be a cause for concern. We have not set timetables on this because in some areaslarge rural areas, for exampleit might be difficult to establish a mechanism for people to come together and there would be a loss of virtual activity. However, perhaps I may come back to the noble Baroness on that important point.

Baroness Howe of Idlicote: Perhaps I may ask one more brief question on this. The Minister said that lots of people would be very happy to see the report but, in the past, it has not been unknown for reports to be sat on or, for one reason or another, not to have seen the light of day either at all or until a big fuss has been made. I should like reassurance that that could not happen or that something in the regulations would prevent it.

Baroness Andrews: A LINk report that covered the entire spectrum of health and social care, with every significant and small body representing a sector, would have to be taken seriously. We are creating a unique organisation here. However, perhaps I may think about the nature of the distribution and the nature of the response to the reports.

Baroness Neuberger: I am grateful to the Minister for everything that she said. She rightly says that she has not wholly reassured me, particularly as we get back yet again to the membership of LINks. Nevertheless, I am enormously grateful that she is taking some of this away to look at again, especially the issue that came up through her response about what happens if a LINk does not come into existence, or takes a long time to do so. We would all be concerned about that, but I am enormously grateful to her, and with that I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Baroness Andrews: moved Amendment No. 239:
	Clause 227, page 158, line 42, after State insert that may be in force at the time

Baroness Andrews: I shall move and speak to the government amendments and to Amendment No. 239A. I will start with that, as the power for the Secretary of State to make directions about what a LINks annual report includes is important.
	The power will not mean that a LINk cannot include issues and matters that it thinks are important, as a LINk is an independent mechanism and can of course highlight areas that it thinks should be made public. Indeed, it could do so at any timedefinitely not only in the annual report. The power enables the Secretary of State to seek the views of LINks on matters that may be of particular importance. For example, it may be that the Department of Health would welcome insights from LINks in developing policies on issues of access to services, or on the impact of legislation such as the Disability Discrimination Act.
	Similarly, the Secretary of State may well wish to be able to take a holistic view of specific aspects of LINks activities; for example, how many people from vulnerable groups have been involved in them. That insight could only be achieved by requiring all LINks to provide information on the same topic. Essentially, then, we are looking for the ability for LINks to populate their reports in a way that enables us to make comparison.
	I now turn to a number of technical amendments to Part 14 of the Bill. Since consideration of the Bill in the other place, its drafting has been reviewed to ensure that a consistent approach is adopted to any provisions relating to directions and guidance. As a result, some amendments are needed to Clause 227 to ensure consistency with the rest of the Bill. Clause 227 deals with LINks' annual reports; subsection 3(a) enables the Secretary of State to give directions about the matters dealt with in a LINks annual report, and subsection 2(d) means that regard must be had to,
	guidance issued by the Secretary of State,
	on how a LINks annual report is to be made publicly available.
	Amendments Nos. 240, 241 and 242 therefore do two things between them. First, they remove the express requirement for directions and guidance under the clause to be in writing, which is to ensure consistency with the rest of the Bill. However, directions and guidance under the clause will still have to be in writing, since subsection (11) requires them to be published.
	Secondly, they remove the express power to vary or revoke guidance given for the purposes of the clause. That is also to ensure consistency with the rest of the Bill. Such an express power is considered unnecessary since guidance may generally be issued, varied or revoked without statutory authority. As a result, including such an express power under this clause might wrongly lead the reader to conclude that there was no power to vary or revoke guidance under other provisions of the Bill.
	Finally, Amendment No. 239 provides that the guidance to be referred to when preparing an annual report is the guidance,
	in force at that time.
	This clarifies the obligation where guidance has been amended over the course of time. Without that clarification, a reader might at first think that the reference was to the guidance in force when the local authority made the arrangements with the LINks host. I beg to move.

Earl Howe: It is a little unusual to have a reply to an opposition amendment before the amendment has even been spoken to, but I revel in that luxury while thanking the noble Baroness for what she said about Amendment No. 239A. That largely satisfied my curiosity, as this was a probing amendment and I felt that in the light of her remarks about the independence of LINks it was a little strange that we should have a power of direction from the Secretary of State over what the LINks had to include in their annual reports. Nevertheless, I can see that in some circumstances there could be merit in this idea, just so long as it is not carried to excess, as then it could constitute an unreasonable infringement into the independence of LINks.

On Question, amendment agreed to.
	[Amendments Nos. 239ZA and 239A not moved.]

Baroness Andrews: moved Amendments Nos. 240 to 242:
	Clause 227, page 160, line 3, leave out , or issue guidance,
	Clause 227, page 160, leave out line 4
	Clause 227, page 160, line 5, leave out , or guidance issued,
	On Question, amendments agreed to.
	Clause 227, as amended, agreed to.
	Clause 228 agreed to.
	Clause 229 [Abolition of Patients' Forums]:
	On Question, Whether Clause 229 shall stand part of the Bill?

Baroness Meacher: I rise to speak to the clause stand part Motions in relation to Clauses 229, 230 and 231. In so doing, I ask the Minister to consider whether she is sufficiently well prepared at this stage to justify abolishing patients' forums, their functions and their parent body, the Commission for Patient and Public Involvement in Health. I also wish to speak to Amendment No. 252A, which would ensure that if LINks are introduced, nothing will be done to abolish PPI forums or the commission until host organisations have been appointed in every local authority area. The purpose of Amendment No. 252A is to ensure that there is not a hiatus between the demise of PPI forums and the creation of LINks, if this is what happens. I hope the Minister will accept that principle.
	I want to focus on the clause stand part Motions. In so doing, I fully accept that patients' forums have been restricted to monitoring health service providers; they have not had a remit for commissioning bodies, as others have mentioned, social care providers or institutions in the criminal justice system, which provide a form of service for many of the most disadvantaged people. There is therefore a need to fill the gaps in the system. I am just not yet convinced that LINks are the best way to do that, and I am not sure how anyone else can be convinced with the present state of knowledge. My main concern is that the world has moved on while the preparatory work has been undertaken for the introduction of LINks. The Government in their paper on local government networks, creating a stronger voice in health and social care, claim that LINks differ from previous systems as they are based on broad networks rather than small specialist groups involving representatives from organisations as well as individuals. Indeed, the Minister indicated that LINks are some incredibly new and unique form of organisation, but I have to say that that statement is not really correct. The model already in place in foundation trusts is similarly based on broad networks and involves representatives from organisations as well as individuals. Indeed, the whole idea of these boards of governors and the membership is that they should cover every conceivable small group, BME community group and so on.
	The Government envisage that all health provider trusts will be foundation trusts by 2008 and that all foundation trusts will have boards of governors, sometimes called members councils, comprising patients, service users, carers, members of the public, representatives of voluntary organisations and, as I have mentioned, BME communities and so forth. The majority of board members are elected by the thousands of public and staff members who have been signed up to each foundation trust. The regulatory authority expects each foundation trust to have between 5,000 and 8,000 members. That is roughly what has been said in relation to LINks; that they should have thousands of members and all the little groups and voluntary organisations. My understanding is that primary care trusts will also become foundation trusts, with boards of governors and a broad membership, so we are all going to be hunting in the same pool, the same borough, if you like, for these thousands of members and for every conceivable group to sign up.
	These clauses in the Bill provide for the abolition of patients' forums to make way for the proposed LINks. My suggestion is that in the health sector it may be more sensible to retain patients' forums at this stage while the LINks pilots, to which I have already referred, are undertaken, while they are evaluated and while the boards of governors are evaluated. They have never been evaluated, so perhaps they are not the right way forwardI am simply saying that we do not know. The question concerning me is whether the introduction of LINks to the health service, as I referred to in relation to the previous debate, will duplicate the structure as well as the work of boards of governors.
	The House of Commons Health Committee report 2006-07 rightly pointed out that the foundation trust system is still in its infancy. I would be the first to say that foundation trust boards of governors will take several years to find their feet, to operate really effectively in representing the interests of patients, service users and carers and to ensure that services respond to those interests and needs. A Peer I was talking to over dinner said that similar organisations that he is aware of have taken 10 years to settle down and be really effective. This is the sort of issue that all of us need to be aware of; these things do not just happen overnight. My point here is that these PPI boards need to be evaluated before anything further is done. Indeed, the Government's regulator, Monitor, warned of the same problem of duplication.
	The situation may not be helped if there are two sets of bodies struggling to find their feet. On the face of it there are possible advantages in either of these two systems. Maybe LINks will be better than boards of governors. Certainly on paper they appear to be more independent. But as I understand these two sets of systems, the boards of governors look to me to be very much stronger and more effective potentially for patients, service users, carers and everybody else.
	The crucial element here is that LINks do not appear to have any powers; what they have is activities. I will just go through some of the powers and responsibilities of these boards of governorsthey are quite interesting. These boards, comprising more than 50 per cent of users and carers, elected quite interesting bodies. The boards of governors must be consulted on forward planning by the board of directors and the board of directors must have regard to their views. They have to explain if they do not put those views into effect. The board of governors must approve the appointment of the chief executive of the trust. The process of this incredibly important appointment must be made under the scrutiny of these boards of governors. The board of governors hires and fires the chairman of these trusts. Will a trust chairman allow the board of directors to disregard the governors in any respect? I do not think so. This is a masterstroke by the Government. It will ensure that every health trust board, whether a commissioner or provider, will in future take full account of their patient service user, carer and public representatives.
	The board of governors, we are told, will represent the interests of the trust's thousands of members and partner organisations in the governance of the trust. The board of governors will hold the board of directors to account for the performance of the trust; that is, the quality of services delivered to patients and service users. The role of LINks appears rather weak by comparison. We are told that they will have a role in promoting and supporting the involvement of people in the commissioning, provision and scrutiny of services. They will be obtaining the views of people about their need for, and experiences of, services. There is no indication that those views will be taken seriously, although the Minister made a useful contribution on that issue. They will be enabling people to monitor and review the commissioning and provision of services. As I have said before, there is a terrible fear of duplication here. They will make their views known to the people responsible for commissioning, providing, managing and scrutinising those services. But they will be at arm's length. The boards of governors are going to be right there; these trusts cannot ignore them. They are independent and they are right there, with these powers and they can report direct to the regulator if they are not happy with the way the trust board treats them.
	The foundation trust boards of governors will regard all the roles of the LINks as essential to the exercise of their powers. The roles under the two systems may look different on paper because the boards of governors have defined powers whereas LINks will have defined activities, but in reality the LINks may simply turn out to be a less powerful form of boards of governors. Certainly the questions relevant to LINks set out on page 18 of the Government's consultation document are precisely the questions that boards of governors will be addressing. But my main point in speaking to these clause stand part motions is that none of us is yet in a position to know whether LINks will have any real value for the health service over and above what we have in the boards of governors.
	I shall mention briefly two further issues. In abolishing the Commission for Patient and Public Involvement in Health, the Government apparently have no plans to create a national body in its place to support the work of the LINks. Noble Lords have already had a bit of a discussion about that, but in my view a national body is essential, and it is of no little interest that the boards of governors have not had a national body. So the Foundation Trust Network, the national body supporting foundation trusts, is now going through the process of setting up a national body to support the boards of governors. If there is going to be a national body for the LINks, we shall then have two national bodies for patient, service user, carer and public user bodies apparently duplicating each other's work.
	Again, and most important, I repeat that the crucial point is that we need pilots and evaluation. I am sure that we all agree that patient and public involvement is central to achieving the high quality services we want, but none should underestimate the difficulties of organising this work, particularly in the mental health field. In my experience, PPI forums have struggled desperately to operate effectively. Rushing into the establishment of LINks, albeit after a lot of discussion and consultation, is a very high-risk strategy. I hope that the noble Baroness will give consideration to the points I have raised.

Lord Rea: Perhaps I may speak briefly to Amendment No. 252A, which the noble Baroness did mention early on in her speech. It seeks simply to ensure that the LINks are up and running before the current fora and the commission are abolished. The changeover from the old system to the new could be compared with runners in a relay race. If it is done in a hurry, the baton may be dropped and the runners will lose touch with each other. I suggest that there should be a whole lap in which the two systems run together before the baton is handed over. It should be done when the skills and experience of the fora and the commission have been handed over properly so that the LINks are functioning well before we say goodbye to the old system.

Earl Howe: I had prepared a great deal to say about these clauses, but I am going to spare the Committee the pleasure of hearing those remarks, although I may bring them back at the Report stage. For now I shall confine myself to just a few brief comments. In her letter of 9 July the Minister said that it was not possible to adapt the current system because of the way that forums are set down in legislation. She said that one would have to change their statutory basis completely. I think I need to understand a little better why that is. It does not seem to be a proposition that is self-evident, and the advantage of that approach as opposed to the one taken by the Government is that it would have afforded a measure of continuity, the lack of which endangers the good will of the volunteers in the field.
	I want to comment on Amendment No. 252A. The abolition of patient forums, we understand, is set for 31 March 2008 and from the Minister's letter of 9 July it seems inevitable that we are facing a gap between their disappearance and the arrival of LINks, the very thing that many of us most want to avoid. In her letter the Minister said:
	We do not believe that a small gap will be a serious concern.
	I disagree with her on that very strongly. I do not know what she means by a small gapperhaps she will tell usbut it has to be a cause of concern that any kind of gap in the provision of patient and public involvement is considered acceptable to her department.
	My questions to the Minister are these. Has a gap been built into the department plans? What steps is the Minister taking to make sure such a gap is avoided? What, if any, financial or organisational obstacles exist to militate against the desirable aim of achieving the smooth transition that many of us want to see?

Baroness Neuberger: I, too, had prepared a quite lengthy speech for these clause stand part debates but, like the noble Earl, Lord Howe, I shall address only a few points because we are running so late.
	On the letter from the Minister of 9 July, I, too, am very concerned about the gap. It is extraordinary for the Minister to say that she does not believe that a small gap is of serious concern. I believe it is a very serious concern and noble Lords all round the Chamber are clear that it is of serious concern. I say that for two reasons. First, if we are serious about patient and public involvement, the shortest of gaps will destroy the drive to do it better and just discourage people. Secondlythe Minister was well aware I was going to raise this point because I have raised it privately with her and the Minister in the other place, Ann Keenthe abolition of the patient forums and treating the volunteers who are part of those patient forums in such a cavalier way is unacceptable. To say that it does not matter if there is a gap suggests that we are better off without them than with them. It is an extraordinary thing for the Government to do.
	The Minister knows that I have had many representations made to me by members of patient forums. She also knows that I have this new and somewhat strange role as volunteering champion for the Prime Minister. I find myself now in an impossible position as far as the treatment of volunteers in this arena is concerned. The hundreds of people making representations should not be treated in this way.
	I hope the Minister will be able to reassure us that such a gap will not occur and that there will be continuity in patient and public involvement. Even if the systems change and the two run in parallel, as the noble Baroness, Lady Meacher, thinks they will, I hope there will be continuity in patient and public involvement and no gap. Therefore the date of March 2008 does not need to stand.

Baroness Howe of Idlicote: I shall add my words extremely briefly. I have listened to the debate with considerable interest because it summarises the real concerns that we all feel. My noble friend Lady Meacher has made some very interesting points that are well worth considering. We must not have a gap. Equally, what is being suggested shows a vague lack of appreciation of the numbers of bodies and the number of duplications involved. We do not know what they are and it would seem very sensible to carry out research before any gap occurs. Abolition must not take place if we are to have any credibility, as the noble Baroness, Lady Neuberger, said. There is time to do that research, to see what is happening and to see whether there is a suitable existing national body. I am as equally convinced as my noble friend that there is a need for a national body, not only the PPIs.
	It would be a good idea if the Minister could say something to the body which is to be finally abolished after nine resurrections, shall we say. It has done its duty, as it saw it. It might have been yet another example of something ill-considered that was set up far too quickly before it had to be rethought, but that is not its fault. It has been extremely helpful in briefing the rest of us, along with all the people who have written to us from all sorts of different medical, voluntary and patient bodies.
	I hope that there will be some rethinking on the whole issue for the benefit of everyone, not least the Government, and that someone will try to say something nice about the national body to it directly.

Baroness Andrews: I too have a massive speaking note, which I shall discard and try to address as quickly as possible the significant points that have been raised.
	I start with the case made by the noble Baroness, Lady Meacher. I know she thinks that LINks are unnecessary and will duplicate the work of foundation trust boards. They are not unnecessary, for all the reasons I have given in the course of the debate today. They will not overlap with the foundation trust boards, which are doing something very different. They are institution-based, while LINks are area-based and cover social care and healthcare. LINks will include organisations that might have an almost marginal attachment to health, and yet whose members will be affected by health provision. The bodies will do different things in different ways. Although I understand the noble Baroness's anxiety, she should not worry about it in the way she is.
	I repeat what I said earlier: the business of conversions, co-option and co-operation will be the way forward. We are talking about new animals. I remember, when we were debating the passage of the National Health Service reorganisation Bill, we discussed in great detail who would constitute the boards and what they would do. Now here we are, worrying about whether they will overlap with an organisation that is fundamentally different. No doubt we will come back to some of this on Report, but I hope that in the mean time the noble Baroness and I can talk some more about it privately.
	The noble Earl, Lord Howe, asked why we need something separate; why we cannot just evolve a system. He also asked key questions about the transition. The reason we need something new in legislation is simply because LINks are different from PCTs. A patients' forum was established for every trust, while LINks will cover an area. Forums are generally small organisations of seven or eight members, while there is much greater scope for LINks and a different governance arrangement. Forums have been established for NHS institutions, while LINks will look at both healthcare and social care. We have not spoken today about just how significant a change that is, and how maddening and frustrating it has been over the years that healthcare and social care have been separate, with all the disability that that has built into the system. LINks will support capacity in the local and voluntary sectors in different ways and will tap into the excellent work and experience that already exists. For all those reasons this is a fresh start.
	We want a transition that is as smooth and easy as possible. I take the noble Baroness's point that people have made a commitment, and once you lose your purpose as a volunteer it is easy never to return. It is very difficult to recapture that enthusiasm, and local authorities must think about that as they move into contracting organisations, since those are the people who will deliver for them.
	When I spoke about a small gap, I was trying to be as honest and realistic with noble Lords as possible, maybe to take them into my confidence. We could not realistically expect to establish new bodies without some sort of changeover, and it was better to admit the possibility that not every LINk would be up and running in March next year rather than to be overconfident. We must be careful. We are trying to learn from experience.
	As for how small is a small gap, it is difficult to quantify. There were two reasons why we have had to move in this way. I will not go through the clause stand part but will move instead to the substance of the amendment. We have been in this situation since 2004. There has been a great deal of uncertainty and anxiety. We have not exactly rushed into this but there has been a build-up of anxiety, which we need to address and resolve. For the past two years, forum members have said to us, Whatever you decide, decide quickly because we need to move on. That is an important point. We are creating a new system with a fresh starta step change.
	What will we do to achieve a smooth transition? I will not go through all the detail but it includes everything that we set out in the letter to noble Lords. We knew that the timing would be contentious so we put activity in place early on to inform and mobilise people. Local authorities need to be thinking about hosts. Three-quarters of them already have someone in place whose responsibility it is to identify the host.
	We have put a raft of activities in place to inform stakeholders; we have been holding regional events over the past couple of months with key stakeholders and there is the work of the early adopter projects. Many local authorities are starting work to warm up the potential host market and will report back to us. Many are planning to run events as well as mapping local activity and bringing together local partners, but the crucial thing is to have the host in place. There is considerable interest from organisations that would like to do that and we will shortly be providing them with model contracts. Local authorities will be under a statutory duty to make contractual arrangements. We are soon to write to all local authorities attaching the model specification. After that, the documentation will make it clear that local authorities can carry out activity now to kick-start the arrangements.
	Activities include identifying lead personnel; identifying prospective host organisations; raising awareness among potential hosts; telling the media what LINks will do; trying to suss out who might be interested in being a host; putting in place a draft timetable and project plan; keeping track of the progress of the Bill; bringing stakeholders together; and mapping who will be involved. Local authorities will be encouraged to get together with neighbouring authorities to talk about jointly procuring a host organisation to support more than one LINk, for example.
	I have spoken about the regional rotas. There is a monthly newsletter. We are working with the Centre for Public Scrutiny, the Healthcare Commission, CSCI, the care services improvement partnerships, the NHS National Centre for Involvement, and so on.
	Procurement work starts in August. Some local authorities have already done this, giving them time to have in place contracts with hosts prior to the closure of forums. There is much to be done. There is also anxiety and uncertainty, and it is our job to build confidence and overcome that. It is a major change, which is why we are working across the field.
	On Amendment No. 252A, of course I understand why noble Lords are anxious about this issue, and I applaud them for it. We intend to commence the legislation in such a way as to support a straightforward move into LINks. If the amendment were accepted, however, all patient forums, as well as the Commission for Patient and Public Involvement in Health, would remain in place until every local authority had made contractual arrangements for LINk activities. If even one local authority was slow to establish a LINk for its area, every other area would have to run two systems in parallel. That would be very impractical; the same people would be involved and it would be very expensive to scrutinise the same services. It does not make sense.
	Over the next two or three months, the picture will become much clearer. When we come back on Report, there will be more clarity and visibility about the progress that has been made.

Baroness Neuberger: The Minister made a valiant attempt to tell us that all will be well. She told us how all the local authorities were finding hosts and how CSCI and everybody else was involved, but what she did not say, which seems key, is that the patient forums, which are the early adopters and are trying to move towards becoming LINks, are asking why the pace is so rapid. There seems to be a great impetus within the Department of Health to have the mergers and the changes in the various regulatory and arm's-length bodies in place by March 2008. However, those early adopter patient forums are saying, in terms, This is too fast. We can't do it at that pace. It is fine for the local authorities to be activeit is absolutely great if they are trying to find hostsbut if the early adopters are saying that it is too fast and if the right reverend Prelate the Bishop of Peterborough is saying, Come on, guys, let's go for evolution, not revolution, do we not have to listen a little harder?

Baroness Andrews: We listened in particular to the patient forums saying that they wanted closure and an end to uncertainty. That is what has inspired what we are trying to do. I am not sure what there would be to gain from delay, because people find ways of spinning things out. Timetables are important. We could have had many more early adopters. All over the country, people were really interested not in being pilots, because these are not pilots, but in testing out the way things might happen in the future. However, I am listening to what the noble Baroness says. We will certainly have an opportunity to talk to the early adopters during the summer.

Baroness Meacher: The Minister did not respond to the point about the need for pilots. She just said that delaying would not be a good idea. The one reason for allowing a little more time would be to give the Government the time not just to have some more early adopters but also to set up and pilot some LINks in a particular area, really making sure that they can work in the social care and other sectors. It will be incredibly difficult to turn them into effective and efficient organisationsthis is tough territory. It will be a pity if, in five years, they are being wound up as yet another failure, but I have to say that it is difficult to anticipate that they will not be in that position unless they are piloted.

Baroness Andrews: They were not piloted, I think, because we thought that the lessons about new ways of working were better and more effectively learnt by a more iterative process. The trouble with pilots is that they often take a long time, to be evaluated not least, and they test everything at the same time, whereas we were looking for a way in which different sorts of organisation could test different bits of a new system. That is my understanding at least.

Clause 229 agreed to.
	Clauses 230 and 231 agreed to.
	Clause 232 [Duty to consult users of health services]:

Earl Howe: moved Amendment No. 242ZA:
	Clause 232, page 162, line 35, after services insert and members of the public

Earl Howe: I shall speak also to Amendment No. 242A. I pointed out at Second Reading that, in one particular respect, Clause 232 did something which was highly regrettable. It is to that issue that I return. Section 11 of the Health and Social Care Act 2001, which became Section 242 of the NHS Act 2006, placed a duty on NHS bodies to ensure that service users are,
	involved in and consulted on,
	the planning of the provision of health services and any proposed changes in those services. I paraphrase the duty slightly, but the words that I wish to emphasise here are involved in.
	Clause 232 amends Section 11if I may continue to call it thatand in so doing removes the words involved in, keeping only the words consulted on. There is an obvious irony in the fact that a Bill that contains involvement in its title should remove that very concept from a key part of the Bill. Why have the Government done this? According to the Minister's letter of 9 July, it was because of the judicial review in the case of north-east Derbyshire, when the judge found it difficult to perceive any real difference between involve and consult, so involve has been taken out. In her letter, the Minister said that she did not think that anything would be lost by doing that. I must respectfully beg to differ with her on thatand, equally respectfully, with the judge in the case of north-east Derbyshire.
	There really is a material difference between involvement and consultation; that difference can most easily be described in terms of the before and after duties. The before duty is about the NHS having a dialogue with patients and the public when proposals are first being formulated. Involvement is the word that describes how patients and the public develop ideas as equal partners with the NHS. Consultationthe after dutyis what happens when that initial planning stage is over. It is about giving people the opportunity to comment on plans that have already been formulated.
	I think that we all understand the difference between the two processes. To take an example, involvement in a review of a service for older people would include setting the review's terms of reference and suggesting what extra services might be needed so they could be considered as the review rolled out. Consultation on such a review would mean commenting afterwards on a set of fully formed proposals. There is a potential source of confusion here because commenting afterwards is provided for already in Section 7 of the Health and Social Care Act 2001 and its accompanying regulations. This is the section now translated into the 2006 NHS Act, which obliges NHS bodies to consult the local overview and scrutiny committee on developments and variations in services. It is true that the Section 7 duty applies to substantial variations and developments in services, whereas Section 11 applies much more generally, but it is most confusing to have consult in both contexts. If it is intended to mean the same thing in both cases, it seems rather pointlessbecause, if people have been consulted about a substantial variation as it has developed, what on earth is the point of consulting them again after their views have been taken account of? If, on the other hand, it is intended that in Clause 232 consult should in practice mean involve, surely that is the word that should be brought back into the drafting.
	Why has the change been made? I am certainly not clear about itand, as I have said, it is a change that is likely to generate confusion in all quarters.
	The point of Amendment No. 242ZA is to widen the definition of those who should be consulted to those members of the public who may not be direct users of services but who nevertheless have an interest in them. This might, for example, include parents of children who are users or friends and carers of people with mental health problems. In fact, it could include anyone with an interest in improving care services, which is surely what we would expect to happen if, to take a typical case, primary care services were being reconfigured in a particular area. It is not just the users of those services who have an interest in what is decided but a much wider group of people, including those whom those services are not properly reaching. I beg to move.

Baroness Morgan of Drefelin: I am not sure I can give the noble Earl the comfort that he seeks. I shall do my best, but I fear that we may need another round of letters. Amendment No. 242ZA seeks to ensure that the duty on NHS bodies to consult, which is set out in Clause 232, is a duty to consult not only users of services but the public in general, as he explained. That is, however, unnecessary, as this is already captured by new subsection (1F) in Clause 232, which defines a user of health services as,
	someone to whom those services are being or may be provided.
	I entirely understand his point about relatives or carers. I might have to read Hansard and think carefully about the point he is making to see whether the definition encompasses the additional groups he is talking about.
	On Amendment No. 242A, I am not sure I can help the noble Earl. I am not at all surprised that he raises this point and I am very interested in the points he makes. This amendment seeks to retain the original wording of Section 11 of the Health and Social Care Act 2001, which has since become Section 242 of the consolidated NHS Act 2006, which gives NHS bodies a duty to involve and consult patients and the public. On the noble Earl's analysis, I can confirm that during a judicial review into Section 11 in north-east Derbyshire, the judge found it difficult to perceive any real difference between involve and consult. We have taken this on board and have revised the section, not to reduce the requirement but rather to clarify our expectations of the NHS. We have retained consult because it fully reflects what we want the NHS to do, which is to seek the views of patients and the public in the planning of the provision of services and in developments of proposals, and to ensure that people are consulted on decisions affecting the operation of services. I am happy to write to noble Lords explaining the legal basis for the use of consult, and demonstrate that this fully covers all the activities that are described in the old Section 242 under involve and consult.
	I think this is a good time to mention one of the ways we are strengthening the duty of consultation. We are placing a requirement on NHS bodies to have regard to statutory guidance issued by the Secretary of State. Currently this is not the position and we think explicit expectations set out in guidance will provide considerable help to the NHS in fulfilling the duty.
	The guidance will set out clearly examples of when it is appropriate to consult under Section 242 and what form that consultation should take. This will clarify what the expectations are for NHS organisations to comply with their duties and perform better user engagement. The work to deliver the guidance to Section 242 will cover a range of stakeholder consultations and will include regional road shows and reference group workshops. That engagement activity will include input into the early drafts of the guidance and the testing of the text as it develops. The Department of Health is very confident that the statutory guidance will go a long way to support more effective involvement and consultation. With an undertaking to write further, I hope that at this stage the noble Earl will consider withdrawing his amendment.

Earl Howe: I am grateful to the noble Baroness for her reply and for her offer to write to me, which I look forward to. Some of her latter remarks on Amendment No. 242A were rather like dancing on the head of a pin. The arguments she advances seem, if I may say so, rather circularand is it a good use of parliamentary time to amend a legislative provision from involve to consult and then issue guidance to say that consult actually means involve? I say to her very humbly that the law has to be clear. The man and the woman in the street needs to know to what they are entitled, and the NHS needs to know what it is supposed to be doing: nobody gains by having obscure language. I still think the clause needs to be clearer in the Bill and I have little doubt that we will return to the issue at a later stage, regardless of the letter that the Minister has kindly undertaken to send. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.
	[Amendments Nos. 242A and 242B not moved.]

Earl Howe: moved Amendment No. 242C:
	Clause 232, page 162, line 37, leave out significant

Earl Howe: I will also speak Amendment No. 242D. The amendment poses what I consider to be an extremely difficult set of questions. I would like, first, to direct to the Minister's attention to the regulations made under Section 7 of the Health and Social Care Act 2001. These refer to when an NHS body is thinking about a substantial development of local health services or a substantial variation in the provision of a service, and provides that it must in those circumstances consult the overview and scrutiny committee of a local authority. Specifically, it says that:
	Where a local NHS body has under consideration any proposal for a substantial development of the health service in the area off a local authority, or for a substantial variation in the provision of such service, it shall consult the overview and scrutiny committee of that authority.
	Let us take an example. There is, let us imagine, a proposal to develop renal services in a local authority area. Even if the proposal is not substantial or significant, under new Section 1B(a) of the Bill, planning to address it will still require consultation with patients. If it leads to proposals that are significantthat is, having a substantial impact on delivery of servicesit will require consultation under new Section 1B(b). If it starts to involve a substantial development or substantial variation, it will require public consultation with the overview and scrutiny committee under Section 7 of the Health and Social Care Act.
	The first question is: at what point during the consideration of this proposal on renal services does Section 7 kick in? The answer has to be: as soon as it is understood that the proposal is for a substantial development or variation in the provision of a service. But what does that mean? In the context of Section 7 of the Health and Social Care Act, case law has helped to define what is meant by substantial variation and development. On the one hand, there is case law, and on the other, with the passing of this Bill, there will be statute law. As a result, we potentially have two different definitions to wrestle with: substantial as understood in the light of existing case law; and significant contained in Clause 232. We could, therefore, have a situation where it is considered that a change proposal or an operational decision is not going to have substantial impact on the delivery of services, but where nevertheless two apparently competing definitions come into play. One may dictate, under new Section 1B(b) and (c) that consultation with patients is not required and the other may dictate that consultation with the overview and scrutiny committee is required. At the very least, the situation is fiendishly complicated. It will lead to all sorts of confusion in the NHS and among LINks membersconfusion which is likely only to be settled by a court of law. I really would like the Minister to explain how she envisages all that working.
	Setting that confusion to one side for the moment, what is wrong with the insertion of significant? In brief, it is that it will constrain dialogue between the health service and local communities in an unhelpful way. We surely want a grown-up relationship between both parties. We want mutual understanding and the kind of embedded public involvement recommended in the report of the Bristol inquiry. The insertion of significant is detrimental to that.
	On Amendment No. 242D, there may be an argument for excluding operational decisions that are not significant. However, I have to ask the Minister where the evidence is that this has been a problem in the four or five years since the Health and Social Care Act came into force. I am not aware that it has been a problem; on the contrary, it seems likely that a better understanding of the operational difficulties of the NHS would make public expectations more realistic. In the absence of such evidence, it would seem foolish to dispense with the only means that the NHS and the public have to sit down together and solve the problems of the NHS in a grown-up way. Constraining that dialogue stifles the sort of relationship that I have just referred to and is counterproductive. I beg to move.

Baroness Neuberger: Amendment No. 242E is consequential on Amendments Nos. 242C and 242D. The noble Earl, Lord Howe, has made the case powerfully on why the use of the word significant is a mistake. North-east Derbyshire has caused a lot of trouble here and it is clear that the Department of Health feels that it would have been easier to win the day in court if significant were included. However, I refer the Minister to the views of Candy Morris, of the South East Coast Strategic Health Authority, and Richard Stein, a lawyer, in their evidence to the Health Select Committee in the other place. Both argued that there was no need to amend the law relating to the duty to consult, because if the Department of Health approached that in the right spirit, it would work fine.
	The noble Earl is saying that we need to approach this in the right spirit and in a grown-up way. Putting in significant would raise all sorts of questions about who decides what is significantis this change or that change significant? That is not a grown-up way of proceeding. All of us in the Committee take this matter seriously and I hope that we will get some considerable comfort from the Minister.

Baroness Howe of Idlicote: I reinforce that point, because it is significant. The admirable way in which it has been illustrated and described makes one realise even more how important it is to sort this matter out.

Baroness Morgan of Drefelin: I hope that I, too, can enter these discussions in the right spirit. I stress that we take these issues very seriously. I intend to consider carefully the amendments and the points raised by noble Lords and, I hope, to engage in further discussions before Report. This is an extremely important issue.
	Section 242 of the NHS Act, as it stands, is a wide-ranging duty and currently provides no sense of scale to enable NHS bodies to apply the duty meaningfully. Furthermore, without some kind of threshold, that duty has the potential to bring about that often-heard complaint of consultation fatigue. It is with a view to that challenge that the word significant has been introduced. By inserting a threshold, we are aiming to ensure that consultation under Section 242 for English bodies is fulfilled when there is a change that has a substantial impact on the range of services and the manner of their delivery. Without these thresholds, NHS bodies would have to consult patients and the public on even the most minor changes. However, I have heard very clearly the points made around the Chamber and, as I have said, we would like to consider further these amendments and remit further before Report.

Earl Howe: I am grateful to the Minister for saying that she will do that. That is most helpful. As the noble Baroness, Lady Neuberger, said, this whole issue is about approaching the involvement and consultation exercise in the right spirit and in a real sense, the way that the Government have amended Section 11 is missing the point of patient and public involvement. If the dialogue between local communities and health and social care providers is as it should be, there will be a greater understanding of the constraints under which such services operatea point made by Wanless in his reportand therefore much more realistic demands from the public. If that relationship is mature, you will not get the NHS overburdened by excessive amounts of trivial consultation. I hope this is an area we can progress between now and Report. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.
	[Amendments Nos. 242D to 242F not moved.]
	Clause 232 agreed to.
	Clause 233 [Primary Care Trusts: reports on consultation]:

Earl Howe: moved Amendment No. 242G:
	Clause 233, page 163, line 36, after the insert public

Earl Howe: I will speak also to the other amendments in this group, Amendments Nos. 242H, 242HA and 242J. In this final group of amendments we have reached Clause 233, which relates to PCTs and the reports that they are to be required to make on any consultations that they may have carried out. I begin with a very simple issue flagged up in Amendment No. 242G. What do the Government mean by consultation? Consultation in the minds of most of us is a public process. If we take the Bill as it is, a PCT might be allowed to suppose that it could confine its consultations to an internal audience, merely sounding out the views of trusts, GPs or local authorities. That kind of narrow exercise would not meet most people's ideas of a proper consultation. I think the Bill needs to be clearer about this.
	In Amendment No. 242HA, I am raising another issue. I must apologise to the Committee that the amendment is rather clumsily shoehorned into Clause 233 in this fashion. I should have taken the time to compose a completely separate new clause to deal with the point, which is to ask the Minister why, if PCTs have a duty to report on consultations, no corresponding duty is placed on strategic health authorities. Strategic health authorities, as we know, are directly responsible for commissioning a range of services, not least specialist and tertiary services. A duty to consult is quite rightly imposed on them in Clause 232. Why should they not have to account for such consultations in a transparent and public way exactly as PCTs will have to do?
	Finally, in Amendments Nos. 242H and 242J, I want to flag up a particularly serious concern about the kind of commissioning that may or may not be covered by this clause. In subsection (3)(e), the Secretary of State is given a power to define what counts as a commissioning decision and he can do so by using his powers of direction. I worry about this on several levels. First, the Secretary of State can act without any public consultation and without the discipline of any parliamentary process. Secondly, there is a huge potential here to erode the accountability of the NHS to the public over a period. What is the Minister's response to that and in what way do the Government intend this power of direction to be used? I beg to move.

Baroness Morgan of Drefelin: Amendment No. 242G seeks to make it explicit that the duty on PCTs to report on consultation should relate specifically to consultation with the public. I shall deal with that first. I can see that this amendment is a genuine attempt to clarify the position. However, it inadvertently narrows what the Bill provides. Our intention is that consultation should relate to consultation of the public but it also relates to other groups, including stakeholders and staff. I do not see the need to prescribe so explicitly that it should be public consultation and I therefore hope that the amendment will not be pressed.
	I shall offer some words of explanation about Amendments Nos. 242H and 242J. As Clause 233 (3) makes clear, we wish to provide PCTs with some explicit requirements about matters relating to the new duty to report on consultation. The noble Earl asked about direction-making powers. The direction-making power that is identified in the amendment enables the Secretary of State to set out what kind of commissioning decisions are appropriate for the report. That is a question of reporting rather than what constitutes a commissioning decision.
	In every year a PCT will make hundreds of commissioning decisions about local services. We clearly do not want to create a duty that places by default such a heavy burden of reporting that it prevents a PCT doing its job effectively. However, we want to ensure that key decisions about, for example, the prioritisation of resources across the whole population of a PCT area, or how services per se are configured in the area, certainly should be reported upon.
	We think that directions are the right vehicle for setting out these requirements, backed up by guidance. The guidance, which is part of the same package to which I referred in an earlier debate, is currently being prepared and itself will be a product of wide ranging involvement and consultation.
	I now turn to Amendment No. 242HA, which proposes to place a duty on strategic health authorities to report on their compliance with the Section 242 duty to consult and to report on what influence people's views have had on decisions. Perhaps I should remind noble Lords that SHAs are not service providers or commissioners; they are the organisations that are responsible for the performance management of local NHS organisations and are not responsible themselves for services. Bearing that in mind, it will be the SHA that will be looking to see that PCTs and trusts have complied appropriately with the requirements of Section 242 rather than fulfilling it itself.
	We have put the duty to report firmly on the PCT specifically because it is the PCT that controls the vast majority of money in the NHS and which makes decisions about the use of resources and how that affects the way in which a specific population receives its health services. It is the relationship between the PCT and the population whom it serves that needs to be developed and supported.
	PCTs need to be more open and accountable to local people and the duty to report on consultations is a tangible way in which PCTs can demonstrate that what they are doing is in the best interests of local people. Strategic health authorities have a different role altogether. Although they are listed in the consultation requirements of Section 242it was Section 11it does not impact on them as they are not directly responsible for the planning or provision of services.
	I hope that my comments have been helpful and that the noble Earl will feel able to withdraw the amendment.

Earl Howe: I shall reflect very carefully on what the Minister said about strategic health authorities. I apologise to the Committee if I said anything misleading. It was my firm impression that strategic health authorities were intimately involved in specialised commissioning groups and that therefore they were eminently appropriate bodies to have to report on those activities.

Baroness Morgan of Drefelin: It would be useful for the record to clarify the position on strategic health authorities. The advice I have had is very clear and it might be helpful if I were to write to the noble Earl between now and Report, setting out exactly, and in rather more detail than the hour permits, the whole question of strategic health authorities.

Earl Howe: I am very grateful to the noble Baroness, as I was, incidentally, for her remarks on Amendments Nos. 242H and 242J, which usefully explained the meaning of those parts of the clause, which I had, I must admit, misconstrued. I note what the noble Baroness said about public consultation. I agree that the public may not be the only audience for consultation exercises and that there are other groups who would, in the normal course, be included.
	I wanted to flag up the undesirability of an overly narrow consultation exercise. That, as a matter of custom and practice, would be equally undesirable. I thank the noble Baroness for her reply. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn,
	[Amendments Nos. 242H to 242J not moved.]
	Clause 233 agreed to.
	Clause 234 agreed to.
	Schedule 17 agreed to.

Baroness Morgan of Drefelin: I beg to move that the House do now resume.

Moved accordingly, and, on Question, Motion agreed to.
	House resumed.
	House adjourned at 11.32 pm.